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Background  The purpose of the study to evaluate possibilities of CT-perfusion and PET methods with 18F–FDG and 18F–fluorocholine in the complex diagnosis of hepatocellular carcinoma. The study included the results of PET/CT with 18F–FDG, 18F–FCh and CT-perfusion of the liver in 18 patients with histologically confirmed diagnosis of hepatocellular carcinoma (HCC). Depending on the degree of tumor differentiation, all patients were divided into 3 groups - patients with highly differentiated (6 patients), moderately differentiated (4 patients), and low-differentiated HCC (8 patients).    Results  Average values of maxSUV in the group of patients with highly differentiated HCC in PET/CT with 18F–FDG and 18F- fluorocholine in a solid component of tumor reached 3.51 and 18.24, respectively; in patients with moderately differentiated HCC - 3.91 and 12.32, respectively; in patients with low-differentiated HCC - 9.58 and 9.70, respectively. Average values of CT perfusion imaging in a solid component of the tumor in the group of patients with highly differentiated HCC were the following: BF - 55,33 ml/100 ml/min, BV - 13,71 ml/100 ml, ALP - 52,41 ml/100 ml/min, PVP - 10.81 ml/100 ml/min ( p  ≤ 0,05), in the group of patients with moderately differentiated HCC: BF - 52,78 ml/100 m /min, BV - 12,23 ml/100 ml, ALP - 47,26 ml/100 ml/min, PVP - 9,10 ml/100 ml/min ( p  ≤ 0.05), in the solid component of low-differentiated HCC: BF - 46,96 ml/100 ml/min, BV - 9,49 ml/100 ml, ALP - 40.54 ml/100 ml/min, PVP - 7,66 ml/100 ml/min ( p  ≤ 0,05).    Conclusions  The diagnostic capabilities of the complex of PET/CT techniques with 18F–FDG and 18F–FCh and CT perfusion in a single-scan mode for hepatocellular carcinoma were evaluated for the first time. The obtained data allow to assume that the integrated use of PET with 18F–FDG and 18F–FCh and CT perfusion in a single scan improves the differential diagnostic possibilities of PET/CT diagnostics, which can find application in planning and prognosis of the disease. Due to the small number of patients further study of the problem is required.

Perfusion CT and PET with 18F–FDG and 18F–FCh in the complex diagnosis of hepatocellular carcinoma