Nucl Med Mol Imaging.  2021 Dec;55(6):293-301. 10.1007/s13139-021-00714-6.

Predictors of Macrovascular Invasion and Extrahepatic Metastasis in Treatment Naive Hepatocellular Carcinoma: When Is [ 18 F] FDG PET/ CT Relevant?

Affiliations
  • 1Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
  • 2Department of Nuclear Medicine, National Cancer Institute, All India Institute of Medical Sciences, New Delhi, India

Abstract

Purpose
Hypermetabolic macrovascular invasion (MVI) and extrahepatic metastasis (EHM) occur in aggressive hepatocellular carcinoma (HCC) and carry unfavorable prognosis. [ 18 F] FDG PET/CT, despite having low sensitivity in primary HCC, is valuable in patients with aggressive HCC for detection of hypermetabolic MVI and EHM. The study aimed at identifying the parameters that could predict hypermetabolic MVI and/or EHM in treatment naive HCC patients for tailored approach to utilize [ 18 F] FDG PET/CT.
Methods
Data of 131 treatment naive HCC patients (median age, 60 years; range, 21–80 years; 90.8% males) who underwent [ 18 F] FDG PET/CT were retrospectively analyzed to determine the proportion of patients with hypermetabolic MVI and/or EHM. Logistic regression analysis was performed to define independent predictors of hypermetabolic MVI and/or EHM.
Results
78/131 (59.5%) patients had hypermetabolic MVI and/or EHM. 52/131 (39.7%) patients had EHM. 56/131 (42.7%) patients had hypermetabolic MVI of which, 30 had concomitant EHM with majority (90%; 27/30) having distant metastasis. 26/131 (19.8%) patients had hypermetabolic MVI without EHM while 22/131 (16.8%) patients had EHM without hypermetabolic MVI of which, majority (95.5%; 21/22) had distant metastasis. Hypermetabolic MVI was associated with EHM (χ2 = 7.868; p value = 0.007). AFP > 93.7 ng/ml, SUVmax > 3.5, and maximum tumor size > 5.0 cm were the independent predictors of hypermetabolic MVI and/or EHM.
Conclusion
In treatment naive HCC patients with AFP > 93.7 ng/ml or maximum tumor size > 5.0 cm, [ 18 F] FDG PET/CT can be valuable.

Keyword

Hepatocellular carcinoma; Macrovascular invasion; Extrahepatic metastasis ; [ 18 F] fluorodeoxyglucose ; Positron emission tomography/computed tomography
Full Text Links
  • NMMI
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr