Sae Jung Na1, Jin Kyoung Oh2, Seung Hyup Hyun3, Jeong Won Lee4, Il Ki Hong5, Bong-Il Song6, Tae-Sung Kim7, Jae Seon Eo8, Sung Won Lee9, Ie Ryung Yoo10, Yong An Chung11, Mijin Yun12. 1. Department of Radiology, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. 2. Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea. 3. Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Nuclear Medicine, International St. Mary's Hospital, Catholic Kwandong University College of Medicine, Incheon, Korea. 5. Department of Nuclear Medicine, Kyung Hee University Hospital, School of Medicine, Kyung Hee University, Seoul, Korea. 6. Department of Nuclear Medicine, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea. 7. Department of Nuclear Medicine, Research Institute and Hospital, National Cancer Center, Goyang, Korea. 8. Department of Nuclear Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea. 9. Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea. 10. Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; and. 11. Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea yunmijin@yuhs.ac yongan@catholic.ac.kr. 12. Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Korea yunmijin@yuhs.ac yongan@catholic.ac.kr.
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.
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.
Authors: Binu V John; Sean Aubuchon; Bassam Dahman; Venkata Rajesh Konjeti; Douglas Heuman; Jennifer Hubert; Smitha Thomas; Yangyang Deng; Cynthia Solomon; Latha Thankam Sundaram; Eleanor Love; Amit G Singal; James L Tatum Journal: Liver Transpl Date: 2020-05-08 Impact factor: 5.799
Authors: Mario Jreige; Periklis Mitsakis; Axel Van Der Gucht; Anastasia Pomoni; Marina Silva-Monteiro; Silvano Gnesin; Ariane Boubaker; Marie Nicod-Lalonde; Rafael Duran; John O Prior; Alban Denys; Niklaus Schaefer Journal: Eur J Nucl Med Mol Imaging Date: 2017-02-23 Impact factor: 9.236