In:
Journal of Gastroenterology and Hepatology, Wiley, Vol. 29, No. 9 ( 2014-09), p. 1722-1727
Abstract:
18 F ‐fluorodeoxyglucose ( FDG )‐positron emission tomography ( PET ) may detect primary lesions ( PL s) and extrahepatic metastases ( EHMs ) only in advanced hepatocellular carcinoma ( HCC ) patients. We investigated the requirement of PET and the optimal timing of PET scanning for accurate staging and treatment planning. Methods We conducted a retrospective investigation of 64 HCC patients who underwent PET (median age, 74 years; male/female, 41/23; etiology, 46 hepatitis C virus/4 hepatitis B virus/4 alcoholic/10 others). To determine the best timing for PET examinations, we analyzed PET result‐based recommended treatment changes and characteristics of patients with FDG ‐avid PL s or EHM s. Results FDG ‐avid PL s were detected by PET in 22 patients (34%): 18 with hypervascular PL , 11 with serum α‐fetoprotein levels ≥ 200 ng/mL, and 11 beyond M ilan criteria. EHM s were detected in 21 patients (33%: lymph nodes, 8; lung, 5; abdominal wall, 4; bone, 3; other organs, 4 [including overlapping]). Recommended treatments changed for 16 patients (25%) because of B arcelona C linic L iver C ancer stage increases based on PET scanning. In multivariate analyses, serum α‐fetoprotein levels ≥ 200 ng/mL and beyond M ilan criteria were independent factors for FDG ‐avid PL s and a maximum standardized uptake value ( SUV max) of PLs of ≥ 4.0 was an independent factor for FDG ‐avid EHM s ( P = 0.002, 0.008, and 0.045, respectively). Conclusions PET allows detection of HCC spread in patients with elevated serum α‐fetoprotein levels or those beyond Milan criteria and detects EHM s in patients with PL s with high SUV max values. Optimally timed PET scans can complement conventional imaging for accurate staging and treatment strategy determination.
Type of Medium:
Online Resource
ISSN:
0815-9319
,
1440-1746
DOI:
10.1111/jgh.2014.29.issue-9
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2006782-3
