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¹⁸F-FDG PET/CT in hepatocellular carcinoma: detection of bone metastasis and prediction of prognosis

 Seo, Hyo Jung  ;  Kim, Gun Min  ;  Kim, Joo Hoon  ;  Kang, Won Jun  ;  Choi, Hye Jin 
 NUCLEAR MEDICINE COMMUNICATIONS, Vol.36(3) : 226-233, 2015 
Journal Title
Issue Date
Adult ; Aged ; Bone Neoplasms/diagnosis* ; Bone Neoplasms/diagnostic imaging ; Bone Neoplasms/secondary* ; Bone and Bones/diagnostic imaging ; Carcinoma, Hepatocellular/pathology* ; Female ; Fluorodeoxyglucose F18* ; Humans ; Liver Neoplasms/pathology* ; Middle Aged ; Multimodal Imaging ; Positron-Emission Tomography* ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Survival Analysis ; Tomography, X-Ray Computed*
bone metastasis ; hepatocellular carcinoma ; positron emission tomography ; prognosis
OBJECTIVE: The purpose of this study was to assess the diagnostic accuracy and prognostic value of 18F-fluorodeoxyglucose PET/computed tomography (CT) in bone metastases from hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Of 3912 consecutive HCC patients, 67 patients who had undergone both PET/CT and bone scintigraphy (BS) within a 3-month interval were evaluated. RESULTS: Bone metastases were most frequently found in the pelvis (20%), followed by the lumbar spine (14%) and long bones (13%). PET/CT was significantly more sensitive than BS in region-based analyses, with 273 confirmed bone metastases (96.7 vs. 52.7%, respectively; P<0.001), and in patient-based analyses (99 vs. 85%; P=0.042). The median survival period was 5 (range, 0.4-18) months. On univariate analysis, poor prognostic factors included age (<60 years), multiple bone metastases, lymph node metastasis, high serum α-fetoprotein (≥400 IU/ml), Child-Pugh class B, and high maximum standardized uptake value (SUVmax) of bone metastasis (>5.0). Large metabolic volume (≥200 cm3) of bone metastasis was another poor prognostic factor. On Cox regression analysis, high α-fetoprotein was the only poor prognostic factor with statistical significance. CONCLUSION: PET/CT was more sensitive than BS in bone metastasis from HCC by both patient-based and region-based analyses, and offered additional information on survival. PET/CT can be helpful in early diagnosis and opportune treatment of bone metastasis from HCC.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Won Jun(강원준) ORCID logo https://orcid.org/0000-0002-2107-8160
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Kim, Joo Hoon(김주훈)
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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