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18F-FDG PET/CT Can Predict Survival of Advanced Hepatocellular Carcinoma Patients: A Multicenter Retrospective Cohort Study

Authors
 Sae Jung Na  ;  Jin Kyoung Oh  ;  Seung Hyup Hyun  ;  Jeong Won Lee  ;  Il Ki Hong  ;  Bong-Il Song  ;  Tae-Sung Kim  ;  Jae Seon Eo  ;  Sung Won Lee  ;  Ie Ryung Yoo  ;  Yong An Chung  ;  Mijin Yun 
Citation
 Journal of Nuclear Medicine, Vol.58(5) : 730-736, 2017 
Journal Title
 Journal of Nuclear Medicine 
ISSN
 0161-5505 
Issue Date
2017
MeSH
Adult ; Aged ; Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/mortality* ; Carcinoma, Hepatocellular/therapy ; Cohort Studies ; Female ; Fluorodeoxyglucose F18 ; Humans ; Image Interpretation, Computer- Assisted/methods ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/mortality* ; Liver Neoplasms/therapy ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography/methods ; Positron Emission Tomography Computed Tomography/statistics & numerical data* ; Prevalence ; Prognosis ; Proportional Hazards Models ; Radiopharmaceuticals ; Reproducibility of Results ; Republic of Korea/epidemiology ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Survival Analysis*
Keywords
18F-FDG ; PET/CT ; hepatocellular carcinoma ; prognosis ; survival
Abstract
Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) consists of a heterogeneous group of patients with a wide range of survival times, requiring further prognostic stratification to facilitate treatment allocation. We evaluated the prognostic value of 18F-FDG uptake on PET/CT at the time of presentation in patients with BCLC stage C HCC. Methods: A total of 291 patients with BCLC stage C HCC who underwent 18F-FDG PET/CT between 2009 and 2010 for staging were retrospectively enrolled from 7 university hospitals. The patients were further divided into 2 groups according to the extent of disease, as intrahepatic or extrahepatic. Tumor-to-liver SUV ratio (TLR) of the primary tumor was measured on 18F-FDG PET/CT. Prognostic values of TLR and other clinical variables were analyzed to predict overall survival (OS) in univariate and multivariate analyses. Differences in the OS stratified by TLR were examined by the Kaplan-Meier method. Results: Higher TLR was associated with extrahepatic disease (P = 0.018). On multivariate analysis, Child-Pugh classification and TLR were independent prognostic factors in the intrahepatic disease group (all P < 0.05), whereas TLR was the only independent prognostic factor in the extrahepatic disease group (P < 0.05). Patients with high TLR showed a significantly worse OS than those with low TLR (P < 0.05) in both groups. Conclusion: In patients with BCLC stage C HCC, 18F-FDG uptake in the primary tumor was significantly higher in patients with extrahepatic disease than in those with intrahepatic disease. In addition, 18F-FDG uptake on pretreatment PET/CT had an incremental prognostic value for OS in both intrahepatic and extrahepatic disease groups.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160834
DOI
10.2967/jnumed.116.182022
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실)
Yonsei Authors
윤미진(Yun, Mi Jin)
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Full Text
http://jnm.snmjournals.org/content/58/5/730.long
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