OBJECTIVETo assess the clinical value of (18)F-FDG PET/CT and contrast-enhanced computed tomography (CECT) in detecting residual tumor or tumor recurrence and metastasis in patients with hepatocellular carcinoma (HCC) who show an elevated serum alpha-fetoprotein (AFP) level after surgical intervention.

METHODSThe data of (18)F-FDG PET/CT and CECT, which were performed at an interval within 2 weeks, were reviewed in 54 HCC patients showing elevated AFP levels after surgical interventions of the tumor. The patients were followed up for at least 6 months and the imaging findings were confirmed by pathological examination, follow-up imaging examination, or serum AFP level monitoring.

RESULTSForty-five patients were found to have focal intrahepatic HCC recurrence after surgical interventions, and 9 patients were free of HCC recurrence. Twenty-three patients developed extrahepatic metastasis, among whom 19 also had intrahepatic tumor recurrence and 4 had extrahepatic metastasis only. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT in the detection of HCC recurrence were 88.9% (40/45), 77.8% (7/9), and 87.0% (47/54), respectively, as compared with those of 57.8% (26/45), 100% (9/9), and 64.8% (35/54) by CECT detection.

CONCLUSIONCompared with CECT, (18)F-PET/CT shows a high sensitivity and accuracy in detecting postoperative tumor residual or recurrence in the liver, and can also be an effective modality for detecting extrahepatic lesions in HCC patients.