18F-FSPG PET in Imaging Patients with Liver Cancer before Undergoing Surgery, Transplant or Y90 Radioembolization

Inclusion Criteria

• Diagnosis of HCC with one or more of the following: * Liver mass with non-rim arterial phase hyperenhancement (APHE) and one of the following: ** 10-19 mm with >= 2 additional major features according to Liver Imaging Reporting and Data System (LI-RADS) criteria (“washout”, enhancing “capsule”, and/or threshold growth) ** 10-19 mm with “washout” and visibility at antecedent ultrasound (US) but with no “capsule” or threshold growth ** 10-19 mm with >= 50% size increase in =< 6 months but with no “washout” or “capsule” or ** >= 20 mm with >= 1 additional major feature according to LI-RADS criteria (“washout”, enhancing “capsule”, or threshold growth) * Lesions that meet Liver Imaging Reporting and Data System (LI-RADS) 4 criteria or * Lesions that meet LI-RADS 5 criteria or * Suggestive imaging findings plus AFP > 200 mg/dL; or * Tumor confirmed by arteriography * Pathologic confirmation of tumor or
• Diagnosis of a benign abdominal or pelvic tumor with the following characteristics: * Liver mass (>= 1 cm) that has suggestive imaging findings of a benign liver mass (adenoma, hemangioma, focal nodular hyperplasia) * Prior standard of care (SOC) MRI or CT of the benign lesion within 8 weeks of enrollment or
• Diagnosis of a malignant non-HCC liver tumor with one or more of the following characteristics: * Liver mass (>= 1 cm) that is biopsy proven, MRI-confirmed, or CT-confirmed metastatic disease (metastatic colorectal cancer, metastatic pancreatic cancer) * Liver mass (>= 1 cm) that is a non-HCC primary malignancy (cholangiocarcinoma) * Prior SOC MRI or CT of the malignant non-HCC liver tumor within 8 weeks of enrollment and
• Each patient must have completed conventional imaging and staging and MRI or CT before initiation of the investigational PET studies and
• Patients with HCC must be a candidate for liver resection, orthotopic liver transplant (OLT), or Y90 radioembolization

Exclusion Criteria

• Patients under the age of 18 will be excluded from this study
• Patients who have HCC but are not candidates for liver resection surgery or OL, or Y90 radioembolization
• Pregnant and breastfeeding patients
• Pregnant and breastfeeding patients. Adequate birth control measures (oral, implanted, or barrier methods) must be used by all female participants of childbearing potential until all research PET scans are completed. Female subjects of childbearing potential must have a negative serum or urine pregnancy test within 24 hours of the proposed investigational PET/CT scan(s) prior to injection of the investigational radiopharmaceutical
• Patients with poorly controlled diabetes mellitus (fasting blood glucose level > 200 mg/dL)
• Patients with a known infiltrative variant of HCC