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Investigating the value of pre-treatment 18F-FDG PET/CT in predicting the pathological characteristic of hepatocellular carcinoma and recurrence after liver transplantation

  • Hepatobiliary
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Abstract

Purpose

The aim of this study is to investigate the value of pre-treatment 18F-FDG PET/CT in predicting the pathological characteristic of HCC and recurrence after liver transplantation (LT).

Methods

A total of 34 patients who underwent 18F-FDG PET/CT before LT for HCC and did not receive any other treatment were retrospectively enrolled in the study. The maximal standard uptake value of the tumor (T-SUVmax), normal liver tissues (L-SUVmax), and mediastinal blood pool (B-SUVmax) were derived, followed by the calculations of the T-SUVmax/L-SUVmax (T/L) and the T-SUVmax/B-SUVmax (T/B) ratios. Combined with the post-transplantation pathological results and ROC curve, the performance in predicting the pathological characteristic and the recurrence after LT were evaluated.

Results

The AUCs for T-SUVmax, T/L, and T/B in predicting the pathological grade of tumors were 0.820, 0.784, and 0.806, respectively. Alternatively, the AUCs for T-SUVmax, T/L, and T/B in predicting the recurrence after LT were 0.865, 0.899, and 0.931, respectively. The individual cutoff values were 5.0, 1.7, and 2.2, corresponding to a predication accuracy of 88.2%, 85.3%, and 88.2%, respectively. In addition, the AUCs for T/B in predicting microvascular invasion (mVI) and liver capsular invasion (LCI) were 0.825 and 0.788, respectively.

Conclusion

The pre-treatment 18F-FDG PET/CT is effective for predicting recurrence of HCC after LT. In addition, it demonstrates values for predicting the pathological characteristic of HCC such as pathological grade, mVI, and LCI.

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Funding

This study was supported by the grants from the National Natural Science Foundation of China (82001863) and the Shanghai Sailing Program (19YF1408200).

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Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 Fenglin Road, Shanghai, 200032, People’s Republic of China

    Jing Lv, Hongyan Yin, Wujian Mao & Hongcheng Shi

Authors
  1. Jing Lv
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  2. Hongyan Yin
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  3. Wujian Mao
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  4. Hongcheng Shi
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Contributions

JL and WM participated in research design. JL and HY participated in writing of the article and data analysis. JL and HS participated in performance of the research.

Corresponding author

Correspondence to Hongcheng Shi.

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Conflict of interest

All authors declare that they have no competing interests.

Ethical approval

This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University and conducted in strict accordance to the Declaration of Helsinki proposed in 1975 and revised in 2000. Written informed consent was waived due to its retrospective design.

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Lv, J., Yin, H., Mao, W. et al. Investigating the value of pre-treatment 18F-FDG PET/CT in predicting the pathological characteristic of hepatocellular carcinoma and recurrence after liver transplantation. Abdom Radiol 46, 2490–2497 (2021). https://doi.org/10.1007/s00261-020-02872-1

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