Abstract: Objective To investigate whether ¹⁸F-fluorodexyglucose (FDG) uptake in the primary hepatocellular carcinoma (HCC) correlates with serum α-fetoprotein (AFP). Methods Forty-five patients with histologically confirmed HCC underwent whole-body ¹⁸F-FDG PET examination. Standardized uptake value (SUV) and tumor-to-nontumor ratio of the SUV (SUVratio) were calculated, and the relationship between serum AFP and glucose metabolism in HCC was analyzed. Results Of the 45 cases, the primary tumor and metastatic lymph nodes were clearly displayed on PET images in 43 cases and the well-differentiated tumors were shown negative in the other 2 cases. A linear correlation of the AFP with SUV (r=0.426, P<0.05) and SUVratio (r=0.532, P<0.001) was noted. Conclusion Serum AFP correlates significantly with both SUV and SUN ratio, indicating that AFP is involved in glucose metabolism and cell proliferation in HCC.