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Prognostic Value of Metabolic Tumor Volume and Total Lesion Glycolysis on Preoperative 18F-FDG PET/CT in Patients With Very Early and Early Hepatocellular Carcinoma

 Sang Hyun Hwang  ;  Jeong Won Lee  ;  Ho Jin Cho  ;  Kyung Sik Kim  ;  Gi Hong Choi  ;  Mijin Yun 
 CLINICAL NUCLEAR MEDICINE, Vol.42(1) : 34-39, 2017-01 
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Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular / diagnostic imaging* ; Carcinoma, Hepatocellular / metabolism ; Female ; Fluorodeoxyglucose F18* / metabolism ; Glycolysis* ; Humans ; Liver Neoplasms / diagnostic imaging* ; Liver Neoplasms / metabolism ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography* ; Predictive Value of Tests ; Radiopharmaceuticals*
Purpose: The aim of this article was to evaluate the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) on preoperative F-FDG PET/CT for predicting intrahepatic recurrence-free survival (IHRFS), extrahepatic metastasis-free survival (EHMFS), and overall survival (OS) in patients with very early/early hepatocellular carcinoma (HCC). Patients and methods: We retrospectively enrolled 132 patients with very early/early HCC who underwent F-FDG PET/CT followed by surgery. The maximum tumor SUV-to-mean normal liver SUV ratio, MTV, and TLG were measured for each patient. Prognostic significances of PET/CT parameters and clinicopathologic factors for IHRFS, EHMFS, and OS were evaluated. Cumulative IHRFS, EHMFS, and OS were calculated using the Kaplan-Meier method. Results: Thirty-three (25%) and 21 (15.9%) of 132 patients experienced intrahepatic and extrahepatic recurrence, respectively, during a median follow-up period of 38.1 months. In multivariate analysis, none of the factors were significant for IHRFS. Metabolic tumor volume and TLG were only significant factors for EHMFS and OS (P < 0.05). The 5-year EHMFS rates were 94.8% in patients with low MTV and TLG, and 62.1% and 63.2% in patients with high MTV and TLG, respectively (P < 0.001). The 5-year OS rates were 92.6% and 92.4% in patients with low MTV and TLG, and 63.3% and 64.3% in patients with high MTV and TLG, respectively (P < 0.001). Conclusions: Metabolic tumor volume and TLG on preoperative PET/CT were independent prognostic factors for EHMFS and OS but not IHRFS in patients with very early/early HCC. Therefore, patients with high MTV or TLG should be closely observed for extrahepatic metastasis using systemic evaluations.
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1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Cho, Hojin(조호진) ORCID logo https://orcid.org/0000-0002-8686-172X
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Hwang, Sang Hyun(황상현)
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