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- Title
Efficacy of contrast-enhanced FDG PET/CT in patients awaiting liver transplantation with rising alpha-fetoprotein after bridge therapy of hepatocellular carcinoma.
- Authors
Refaat, Rania; Basha, Mohammad Abd Alkhalik; Hassan, Mohammed Sobhi; Hussein, Rasha S.; El Sammak, Ahmed A.; El Sammak, Dena Abd El Aziz; Radwan, Mohamed Hesham Saleh; Awad, Nahla M.; Saad El-Din, Somaia A.; Elkholy, Engi; Ibrahim, Dina R. D.; Saleh, Shereen A.; Montasser, Iman F.; Said, Hany
- Abstract
<bold>Objective: </bold>To assess the diagnostic accuracy and illustrate positive findings of contrast-enhanced fluorine-18 fluoro-D-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) image in patients awaiting liver transplantation (LT) with rising alpha-fetoprotein (AFP) after bridge therapy of hepatocellular carcinoma (HCC).<bold>Materials and Methods: </bold>This prospective study included 100 patients who were waiting for LT and who previously underwent locoregional therapy (LRT) of HCC. These patients had rising AFP levels on a routine follow-up examination awaiting LT. All patients underwent a contrast-enhanced 18F-FDG PET/CT examination. We calculated for each patient the maximum standardised uptake value (SUVmax) of the tumour and the ratio of the tumoral SUVmax to the normal-liver SUVmax. The diagnostic accuracy and positive contrast-enhanced findings of 18F-FDG PET/CT were established by histopathology and clinical and imaging follow-up as the reference standards.<bold>Results: </bold>Contrast-enhanced 18F-FDG PET/CT detected tumour relapse in 78 patients (13 patients had intrahepatic lesions, 10 patients had extrahepatic metastases and 55 patients with combined lesions). The sensitivity, specificity and accuracy values of contrast-enhanced 18F-FDG PET/CT examination in the detection of HCC recurrence were 92.8%, 94.1% and 93%, respectively. A significant correlation was found between the AFP level and SUVmax ratio (r = 0.2283; p = 0.0224). The best threshold for 18F-FDG PET positivity was >1.21.<bold>Conclusion: </bold>Contrast-enhanced 18F-FDG PET/CT is a valuable tool for the detection of intrahepatic HCC recurrence or extrahepatic metastasis following rising AFP levels after LRT of HCC, and should be incorporated during routine workup awaiting LT.<bold>Key Points: </bold>• 18F-FDG PET/CT is a valuable tool for the detection of HCC recurrence • 18 F-FDG PET/CT should be incorporated during routine workup awaiting liver transplantation • Significant correlation was found between AFP level and SUVmax ratio • The best threshold for 18 F-FDG PET positivity was >1.21 • The ideal cut-off value for AFP was >202.
- Subjects
POSITRON emission tomography; COMPUTED tomography; LIVER transplantation; ALPHA fetoproteins; LIVER cancer; TUMOR treatment; COMPARATIVE studies; DEOXY sugars; HEPATOCELLULAR carcinoma; LONGITUDINAL method; LIVER tumors; RESEARCH methodology; MEDICAL cooperation; RADIOPHARMACEUTICALS; RESEARCH; EVALUATION research; PHARMACODYNAMICS; DIAGNOSIS; THERAPEUTICS
- Publication
European Radiology, 2018, Vol 28, Issue 12, p5356
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-018-5425-z