18F-FECH is a new tracer used in PET synthesized by Nuclear Medical Center of Peking Union Medical College Hospital and is favored for diagnosis of primary brain tumor. 18F-FECH showed a high presence of biological distribution in liver and was rarely used in HCC diagnosis. Recently, we find that 18F-FECH may presents a higher sensitivity in diagnosis of intra- and extra-hepatic lesions of HCC respectively, which are much higher than those of 18F-FDG or 11C-acetate PET scan. Therefore, 18F-FECH PET could be a promising tool in diagnosis and staging, therapy selection and prognostic evaluation for HCC patients. However, more researches are required to assess the accuracy and application prospect of 18F-FECH PET in the diagnosis of HCC.