[¹¹C]acetate PET as a tool for diagnosis of liver steatosis

To investigate [¹¹C]acetate PET-surrogate parameter of fatty acid synthase activity-as suitable tool for diagnosis and monitoring of liver steatosis.

In this retrospective study, data were obtained from 83 prostatic carcinoma patients from 1/2008 to 1/2014. Mean HU was calculated from unenhanced CT of all patients from liver with liver HU less than 40 as threshold for liver steatosis. SUV_max of the liver and of the blood pool in thoracic aorta (as background for calculation of a liver/background ratio [SUV_l/b]) was measured. t test was used with a P < 0.05 considered as statistically significant difference and ROC analysis was used for calculating specificity and sensitivity.

19/83 patients (20%) had diagnosis of hepatic steatosis according to CT. Uptake of [¹¹C]acetate was significantly higher in patients with hepatic steatosis as compared to control group (SUV_max 7.96 ± 2.0 vs. 5.48 ± 2.3 [P < 0.001]). There was also a significant correlation between both SUV_max (r = - 0.52, P < 0.001) and SUV_l/b (r = - 0.59, P < 0.001) with the density (HU) of the liver. In ROC analysis for detection of liver steatosis SUV_max (threshold: 5.86) had a sensitivity of 94% and specificity of 69% with an AUC of 0.81. Increasing body mass index is correlated with the severity of steatosis.

We showed for the first time that hepatic steatosis associates with increased [¹¹C]acetate uptake. Also, severity of steatosis correlates with [¹¹C]acetate uptake. [¹¹C]acetate uptake PET seems promising for the assessment of liver steatosis.