Use of 18F-FDG PET to predict tumor progression and survival in patients with intermediate hepatocellular carcinoma treated by transarterial chemoembolization.
10.3904/kjim.2015.30.3.308
- Author:
Min Jin KIM
1
;
Young Seok KIM
;
Youn Hee CHO
;
Hee Yoon JANG
;
Jeong Yeop SONG
;
Sae Hwan LEE
;
Soung Won JEONG
;
Sang Gyune KIM
;
Jae Young JANG
;
Hong Su KIM
;
Boo Sung KIM
;
Won Hyung LEE
;
Jung Mi PARK
;
Jae Myung LEE
;
Min Hee LEE
;
Deuk Lin CHOI
Author Information
1. Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea. liverkys@schmc.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Carcinoma, hepatocellular;
Fluorodeoxyglucose F18;
Positron-emission tomography;
Tomography, X-ray computed
- MeSH:
Aged;
Carcinoma, Hepatocellular/mortality/*radionuclide imaging/*surgery;
*Chemoembolization, Therapeutic/adverse effects/mortality;
Disease Progression;
Female;
*Fluorodeoxyglucose F18;
Humans;
Kaplan-Meier Estimate;
Liver Neoplasms/mortality/*radionuclide imaging/*surgery;
Male;
Middle Aged;
Multimodal Imaging;
Neoplasm Staging;
*Positron-Emission Tomography;
Predictive Value of Tests;
Proportional Hazards Models;
*Radiopharmaceuticals;
Retrospective Studies;
Risk Factors;
Time Factors;
Tomography, X-Ray Computed;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2015;30(3):308-315
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: 18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG PET) has been used to assess the biological behavior of hepatocellular carcinoma (HCC). In this study, we investigated the usefulness of 18F-FDG PET for predicting tumor progression and survival in patients with intermediate Barcelona Clinic Liver Cancer (BCLC) intermediate-stage HCC treated by transarterial chemoembolization (TACE). METHODS: From February 2006 to March 2013, 210 patients treated with TACE, including 77 patients with BCLC intermediate-stage HCC, underwent examination by 18F-FDG PET. 18F-FDG uptake was calculated based on the tumor maximum (Tmax) standardized uptake value (SUV), the liver mean (Lmean) SUV, and the ratio of the Tmax SUV to the Lmean SUV (Tmax/Lmean). RESULTS: The mean follow-up period for the 77 patients (52 males, 25 females; average age, 63.3 years) was 22.2 months. The median time to progression of HCC in patients with a low Tmax/Lmean (< 1.83) and high Tmax/Lmean (> or = 1.83) was 17 and 6 months, respectively (p < 0.001). The median overall survival time of patients with a low and high Tmax/Lmean was 44 and 14 months, respectively (p = 0.003). Multivariate analysis revealed that the Tmax/Lmean was an independent predictor of overall survival (hazard ratio [HR], 1.96; 95% confidence interval [CI], 1.210 to 3.156; p = 0.006) and tumor progression (HR, 2.05; 95% CI, 1.264 to 3.308; p = 0.004). CONCLUSIONS: 18F-FDG uptake calculated by the Tmax/Lmean using PET predicted tumor progression and survival in patients with BCLC intermediate-stage HCC treated by TACE.
