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18F-Fluorodeoxyglucose PET/CT predicts tumour progression after transarterial chemoembolization in hepatocellular carcinoma

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Abstract

Purpose

18F-FDG PET monitoring of FDG uptake may be a useful tool for assessment of the biological behaviour of hepatocellular carcinoma (HCC). We evaluated the correlation between FDG uptake on 18F-FDG PET and clinical characteristics and prognosis.

Methods

In total, 58 HCC patients undergoing 18F-FDG PET before transarterial chemoembolization (TACE) between May 2007 and May 2010 at Seoul St. Mary’s Hospital were evaluated retrospectively. The predictive value of the ratio of maximal tumour standardized uptake value (SUV) to mean liver SUV (Tsuv max/Lsuv mean) was tested. Primary endpoints were the clinical characteristics and treatment response according to Tsuv max/Lsuv mean. The secondary endpoint was time to progression (TTP).

Results

A high SUV ratio (cutoff value 1.70) correlated significantly with tumour size (≥5 cm) and serum AFP level (≥400 ng/mL). Objective response rates were significantly different between those with a ratio above (15.7 %) and those with a ratio below (66.6 %) the cutoff value (P = 0.023). Patients in the low SUV ratio group had a median TTP of 16.8 months compared with 8.1 months in the high SUV ratio group (P = 0.011). Overall survival in the high SUV ratio group was worse than in the low SUV ratio group (median 56.5 vs. 23.3 months), although the difference was not statistically significant in a multivariate analysis.

Conclusion

Tumour metabolic activity (Tsuv max/Lsuv mean), assessed by PET/CT, is an independent predictor of response to TACE in patients with intermediate-stage HCC. Tsuv max/Lsuv mean can be used to predict tumour progression. Thus, 18F-FDG PET can provide valuable information for prediction of prognosis and aid in decisions regarding treatment strategy.

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Acknowledgment

This work was supported by a National R & D Program grant for cancer control, Ministry of Health, Welfare and Family Affairs, Republic of Korea (R0620390-1).

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Authors and Affiliations

  1. Department of Internal Medicine, College of Medicine, The Catholic University of Korea, #505 Banpodong, Seochogu, 137-040, Seoul, South Korea

    Myeong Jun Song, Si Hyun Bae, Sung Won Lee, Do Sun Song, Hee Yeon Kim, Jong Young Choi & Seung Kew Yoon

  2. Department of Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seochogu, South Korea

    Ie Ryung Yoo

  3. Department of Radiology, College of Medicine, The Catholic University of Korea, Seochogu, South Korea

    Joon-IL Choi, Young June Lee, Ho Jong Chun & Hae Giu Lee

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  1. Myeong Jun Song
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Correspondence to Si Hyun Bae.

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Song, M.J., Bae, S.H., Lee, S.W. et al. 18F-Fluorodeoxyglucose PET/CT predicts tumour progression after transarterial chemoembolization in hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 40, 865–873 (2013). https://doi.org/10.1007/s00259-013-2366-2

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