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Increased hepatic FDG uptake on PET/CT in hepatic sinusoidal obstructive syndrome

 Honsoul Kim  ;  Song-Ee Baek  ;  Jieun Moon  ;  Yun Ho Roh  ;  Narae Lee  ;  Arthur Cho 
 ONCOTARGET , Vol.7(42) : 69024-69031, 2016 
Journal Title
Issue Date
Adult ; Aged ; Female ; Fluorodeoxyglucose F18/pharmacokinetics* ; Gadolinium DTPA/chemistry* ; Hepatic Veno-Occlusive Disease/diagnostic imaging* ; Humans ; Liver/diagnostic imaging* ; Liver/metabolism* ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Platelet Count ; Positron Emission Tomography Computed Tomography* ; Retrospective Studies ; Treatment Outcome
syndrome ; sinusoidal obstruction syndrome
PURPOSE: Imaging features of sinusoidal obstruction syndrome (SOS), an increasingly common drawback of chemotherapy, were evaluated via 18F-fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET/CT).

EXPERIMENTAL DESIGN: This retrospective study was approved by our Institutional Review Board, with a waiver of informed consent. FDG PET/CT studies of 35 patients (male, 24; female, 11; median age, 53.2 years) obtained between January, 2005 and December, 2012 were analyzed before and after systemic chemotherapy. Diagnosis of SOS was based on histologic (n=13) or gadoxetic acid-enhanced MRI (n=22) findings. On PET/CT images, ROIs drawn on non-tumorous liver generated mean standardized uptake value (SUVliver). Total lesion glycolysis of liver (TLGliver) was calculated as: SUVliver × CT-derived hepatic volume. Paired t-test was applied to compare changes before and after SOS.

RESULTS: Mean (±standard error [SE]) values of hepatic volume (baseline, 1307.7±46.2 cm3; SOS, 1395.4±41.3 cm3; p=0.004), SUVliver (baseline, 2.08±0.06; SOS, 2.27±0.07; p=0.02), and TLGliver (baseline, 2697.5±114.5; SOS, 3170.2±134.2; p=0.001) significantly increased with development of SOS. In contrast, mean SUVaorta was unchanged (baseline, 1.53±0.04; SOS, 1.50±0.04; p=0.52).

CONCLUSIONS: Hepatic FDG uptake on PET/CT intensified after onset of SOS and thus may be an inappropriate reference in this setting, potentially skewing chemotherapeutic responses gauged by lesion-to-liver SUV ratio.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hon Soul(김한솔)
Baek, Song Ee(백송이) ORCID logo https://orcid.org/0000-0001-8146-2570
Lee, Na Rae(이나래)
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
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