Glypican-3-Targeted PET/MR Identifies MRI-Indeterminate Early Hepatocellular Carcinoma in Cirrhosis.

Hu, Wenzhu; Li, Mengting; Jiang, Dawei; Cai, Xiong; Lan, Xiaoli · Clin Nucl Med · 2026

case_report · Level V

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Abstract

Glypican-3 (GPC3) is highly expressed in hepatocellular carcinoma. A 72-year-old man with hepatitis B-related cirrhosis and rising alpha-fetoprotein had a small hepatic nodule on gadoxetic acid-enhanced MRI (EOB-MRI). The nodule enlarged on 3 consecutive EOB-MRI examinations during a 5-month follow-up but remained indeterminate for hepatocellular carcinoma. GPC3-targeted PET/MR showed intense uptake in the lesion and no extrahepatic disease, and hepatectomy confirmed moderately differentiated hepatocellular carcinoma with strong GPC3 expression. This case suggests the potential value of GPC3-targeted PET/MR for clarifying MRI-indeterminate early hepatocellular carcinoma.