Prediction of Tumor Recurrence by 18F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Journal of Nuclear Medicine

Dong Soo Lee¹  Myung Chul Lee¹  June-Key Chung¹  Hyun Woo Kwon¹  Kyung-Suk Suh¹  Jeong Won Lee¹  Keon Wook Kang¹  Jin Chul Paeng¹ 

关键词: FDG;    liver transplantation;    PET;    recurrence;    prognosis;   

DOI  :  10.2967/jnumed.108.060574

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

Although several prognostic factors are used to predict recurrence and to select adequate candidates for liver transplantation for hepatocellular carcinoma (HCC), these prognostic factors have some clinical limitations. The purpose of this study was to evaluate 18F-FDG PET as a prognostic factor and to optimize its ability to predict tumor recurrence in liver transplantation for HCC. Methods: The study included a total of 59 HCC patients (45 men and 15 women; mean age ± SD, 56 ± 8 y) who underwent 18F-FDG PET and subsequent orthotopic liver transplantation. All patients were followed up for more than 1 y (mean, 29 ± 17 mo), and recurrence of tumor was monitored. Three PET parametersmaximal standardized uptake value (SUVmax), ratio of tumor SUVmax to normal-liver SUVmax (TSUVmax/LSUVmax), and ratio of tumor SUVmax to normal-liver mean SUV (TSUVmax/LSUVmean)were tested as prognostic factors and compared with conventional prognostic factors. Results: Among the 3 parameters tested, TSUVmax/LSUVmax was the most significant in the prediction of tumor recurrence, with a cutoff value of 1.15. In a multivariate analysis of various prognostic factors including TSUVmax/LSUVmax, serum α-fetoprotein, T stage, size of tumor, and vascular invasion of tumor, TSUVmax/LSUVmax was the most significant, and only vascular invasion of tumor had additional significance. According to TSUVmax/LSUVmax, the 1-y recurrence-free survival rate above the cutoff was markedly different from the rate below the cutoff (97% vs. 57%, P < 0.001). Conclusion: In this study, 18F-FDG PET was an independent and significant predictor of tumor recurrence. In liver transplantation for HCC, 18F-FDG PET can provide effective information on the prognosis for tumor recurrence and the selection of adequate candidates for liver transplantation.

【 授权许可】

Unknown