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

作者：Jeong Won Lee, Jin Chul Paeng, Keon Wook Kang, Hyun Woo Kwon, Kyung‐Suk Suh, June‐Key Chung, Myung Chul Lee, Dong Soo Lee · 发表于：Journal of Nuclear Medicine · 年份：2009 · DOI：10.2967/jnumed.108.060574 · 被引用次数：166 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes、Cancer, Hypoxia, and Metabolism

UNLABELLED: 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 (18)F-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 (18)F-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 parameters-maximal standardized uptake value (SUV(max)), ratio of tumor SUV(max) to normal-liver SUV(max) (T(SUVmax)/L(SUVmax)), and ratio of tumor SUV(max) to normal-liver mean SUV (T(SUVmax)/L(SUVmean))-were tested as prognostic factors and compared with conventional prognostic factors. RESULTS: Among the 3 parameters tested, T(SUVmax)/L(SUVmax) 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 T(SUVmax)/L(SUVmax), serum alpha-fetoprotein, T stage, size of tumor, and vascular invasion of tumor, T(SUVmax)/L(SUVmax) was the most significant, and only vascular invasion of tumor had additional significance. According to T(SUVmax)/L(SUVmax), the 1-y recurrence-free survival rate ab...