SNM Annual Meeting Abstracts
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

J Nucl Med. 2008; 49 (Supplement 1):346P
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Hugentobler, A.
Right arrow Articles by Agostini, D.
PubMed
Right arrow Articles by Hugentobler, A.
Right arrow Articles by Agostini, D.

Oncology-Clinical Diagnosis: Solid Tumors

Clinical Diagnosis-Solid Tumors Posters

Impact of octreotide treatment on FDG-PET detection of hepatocellular carcinoma (HCC) developed on cirrhosis with insulin resistance

Alexis Hugentobler1, Karine Bouhier1, Sylvie Costo1, Vincent Dunet1, Thong Dao1, Marie-Astrid Piquet1, Damien Peyronnet1, Gerard Bouvard1 and Denis Agostini1

1 CHU Cote de Nacre, Caen, France

1465

Objectives: FDG-PET has a low sensitivity (40%)in the diagnosis of HCC. We postulate that insulin resistance in cirrhosis increased FDG liver uptake (background noise) and decrease HCC contrast with surrounding liver. Octreotide treatment can correct insulin resistance in cirrhosis .In a preliminary study of 26 patients (13 cirrhotic/13 healthy liver) mean SUVbw was significantly lower in healthy liver. This study evaluate the interest of insulin resistance correction to improve FDG-PET detection of HCC on cirrhosis.

Methods: In 5 cirrhotic patients euglycemic insulin clamp was achieved before any treatment to verify insulin resistance status and after 4 days of octreotide treatment (200 µg/day IV) to be sure that insulin resistance is corrected. Each patient underwent 2 FDG PET : first within 7 days before octreotide treatment and the second on the day 4. Ratio T/N was calculated : mean SUVbw HCC/ mean SUVbw surrounding liver using same Region Of Interest size.

Results: 16 HCC nodules were evaluated. All patients treated with octreotide showed reduction of their insulin resistance by decreasing the fasting hyperinsulinemia (9.76 ± 3.8 vs 2.5 ± 6 mU / l, p <0.05) and increasing glucose utilization during the clamp. The tumor mean SUVbw increased significantly after octreotide (3.77 ± 1.95 vs. 5.74 ± 4.79, p <0.05) whereas the mean SUV bw in cirrhotic non-tumoral liver did not significally change (2.26 ± 0.47 vs 2.82 ± 0.69; NS). In 3/5 patients mean SUVbw T/N ratio (contrast) was increased and an additional HCC nodule was visualised.

Conclusions: Correction of insulin resistance by octreotide improves HCC contrast in FDG PET in the majority of case (3/5). But FDG increased uptake in HCC is not clearly associated with lower background uptake of the liver.





Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Google Scholar
Right arrow Articles by Hugentobler, A.
Right arrow Articles by Agostini, D.
PubMed
Right arrow Articles by Hugentobler, A.
Right arrow Articles by Agostini, D.