Overview
The purpose of this research is to know whether 68Ga-PSMA PET/MRI or PET/CT can improve upon the diagnosis and management of hepatocellular carcinoma.
Description
As part of this proposal, we seek to combine the molecular information obtained from PSMA PET with high-resolution anatomic and functional information from simultaneously acquired contrast-enhanced MRI, the current gold standard for HCC imaging, or contrast-enhanced CT to evaluate PSMA as both a diagnostic and therapeutic response imaging biomarker.
- Better characterize the uptake of PSMA in HCC. This would be a first step towards determining if 68Ga-PSMA PET/MRI (or PET/CT) consisting of focused liver acquisition and whole-body acquisition can be a 'one-stop-shop' for evaluating primary intrahepatic and metastatic extrahepatic hepatocellular carcinoma.
- Establish PSMA as an imaging biomarker for treatment response assessment in HCC for translation to practice and to clinical trials
- Establish PSMA as a theranostic target for 177Lu-PSMA-radio-ligand therapy as a novel therapeutic option for HCC
Eligibility
Inclusion Criteria:
- Patients with either an imaging diagnosis of HCC by CT or MRI (LI-RADS 5) confirmed by a board-certified abdominal radiologist, or with biopsy-proven HCC
- No prior treatment for HCC
- Subjects who may undergo hepatic surgical resection, liver transplant or hepatic locoregional therapy (ablation, embolization)
- Male or female with age greater than 18 years, with the capacity and willingness to provide a written informed consent.
Exclusion Criteria:
- Subjects requiring emergent surgery for a ruptured/bleeding HCC
- Bilirubin > 3.0 mg/dL, which is a contraindication for Gadoxetate, the MRI contrast agent (relevant to PET/MRI)
- Pregnant and/or breast-feeding subjects. A negative pregnancy test within 48 hours of the PET scan.
- Subjects with higher than the weight/size limitations of PET/MRI or PET/CT scanner.
- Subjects with contraindication to MRI (relevant to PET/MRI):
- Subjects who have a heart pacemaker.
- Subjects who have a metallic foreign body (metal sliver) in their eye, or who have an aneurysm clip in their brain.
- Subjects who have implanted devices with magnets.
- Subjects who have other implanted electronic devices.
- Subjects who have deep brain stimulator.
- Subjects who have vagal nerve stimulator.
- Subjects with cochlear (ear) or auditory implants