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Volumetric parameters on FDG PET can predict early intrahepatic recurrence-free survival in patients with hepatocellular carcinoma after curative surgical resection

 Jeong Won Lee  ;  Sang Hyun Hwang  ;  Hyun Jeong Kim  ;  Dongwoo Kim  ;  Arthur Cho  ;  Mijin Yun 
 European Journal of Nuclear Medicine and Molecular Imaging, Vol.44(12) : 1984-1994, 2017 
Journal Title
 European Journal of Nuclear Medicine and Molecular Imaging 
Issue Date
Carcinoma, Hepatocellular/diagnostic imaging* ; Carcinoma, Hepatocellular/surgery* ; Disease-Free Survival ; Female ; Fluorodeoxyglucose F18* ; Humans ; Liver Neoplasms/diagnostic imaging* ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Positron-Emission Tomography* ; Retrospective Studies
FDG PET ; Hepatocellular carcinoma ; Metabolic tumor volume ; Prognosis ; Recurrence
PURPOSE: This study assessed the prognostic values of volumetric parameters on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) in predicting early intrahepatic recurrence-free survival (RFS) after curative resection in patients with hepatocellular carcinoma (HCC). METHODS: A retrospective analysis was performed on 242 patients with HCC who underwent staging FDG PET and subsequent curative surgical resection. The tumor-to-non-tumorous liver uptake ratio, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) of the HCC lesions on PET were measured. The prognostic values of clinical factors and PET parameters for predicting overall RFS, overall survival (OS), extrahepatic RFS, and early and late intrahepatic RFS were assessed. RESULTS: The median follow-up period was 54.7 months, during which 110 patients (45.5%) experienced HCC recurrence and 62 (25.6%) died. Patients with extrahepatic and early intrahepatic recurrence showed worse OS than did those with no recurrence or late intrahepatic recurrence (p < 0.001). Serum bilirubin level, MTV, and TLG were independent prognostic factors for overall RFS and OS (p < 0.05). Only MTV and TLG were prognostic for extrahepatic RFS (p < 0.05). Serum alpha-fetoprotein and bilirubin levels, MTV, and TLG were prognostic for early intrahepatic RFS (p < 0.05) and hepatitis C virus (HCV) positivity and serum albumin level were independently prognostic for late intrahepatic RFS (p < 0.05). CONCLUSION: Intrahepatic recurrence showed different prognoses according to the time interval of recurrence in which early recurrence had as poor survival as extrahepatic recurrence. MTV and TLG on initial staging PET were significant independent factors for predicting early intrahepatic and extrahepatic RFS in patients with HCC after curative resection. Only HCV positivity and serum albumin level were significant for late intrahepatic RFS, which is mainly attributable to the de novo formation of new primary HCC.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
김동우(Kim, Dongwoo) ORCID logo https://orcid.org/0000-0002-1723-604X
김현정(Kim, Hyun Jeong) ORCID logo https://orcid.org/0000-0002-3116-8848
윤미진(Yun, Mi Jin) ORCID logo https://orcid.org/0000-0002-1712-163X
조응혁(Cho, Arthur Eung Hyuck) ORCID logo https://orcid.org/0000-0001-8670-2473
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