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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 3/2010

01-03-2010 | Original Article

FDG PET as a prognostic predictor in the early post-therapeutic evaluation for unresectable hepatocellular carcinoma

Authors: Tatsuya Higashi, Etsuro Hatano, Iwao Ikai, Ryuichi Nishii, Yuji Nakamoto, Koichi Ishizu, Tsuyoshi Suga, Hidekazu Kawashima, Kaori Togashi, Satoru Seo, Koji Kitamura, Yasuji Takada, Shinji Kamimoto

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 3/2010

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Abstract

Purpose

To elucidate the prognostic role of post-therapeutic 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET), we conducted a retrospective cohort study analysing the clinical factors that affect overall survival after non-operative therapy for unresectable hepatocellular carcinoma (HCC).

Methods

Sixty-seven cases with unresectable HCC who received non-operative therapy (transcatheter arterial chemoembolization: n = 24, transcatheter arterial infusion chemotherapy: n = 31, radiofrequency ablation: n = 5 or systemic chemotherapy: n = 7) and had received FDG PET for the evaluation of the therapeutic effect within 1 month after the end of the therapy were evaluated. Overall survival rate was evaluated using the univariate and multivariate analyses of relevant clinical and laboratory parameters before and after therapy, including visual PET analysis and quantitative analysis using maximum standardized uptake value (SUV).

Results

Visual PET diagnosis of post-therapeutic lesions was a good predictor of overall survival of unresectable HCC patients. The low FDG group showed significantly longer survival (average: 608 days) than that (average: 328 days) of the high FDG group (p < 0.0001). Multivariate analysis showed four significant prognostic factors for the survival: post-therapeutic alpha-fetoprotein (αFP) level (=400 ng/ml, p = 0.004), post-therapeutic visual PET diagnosis (p = 0.006), post-therapeutic clinical stage (UICC stage IV, p = 0.04) and post-therapeutic Milan criteria (p = 0.03), while pre-therapeutic clinical factors, SUV by post-therapeutic FDG PET (5.0 or more) or others did not show significance.

Conclusion

The present study suggests that post-therapeutic PET performed within 1 month after non-operative therapy can be a good predictor of overall survival in unresectable HCC patients, while pre-therapeutic evaluation including PET, tumour markers and clinical staging may not be useful.
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Metadata
Title
FDG PET as a prognostic predictor in the early post-therapeutic evaluation for unresectable hepatocellular carcinoma
Authors
Tatsuya Higashi
Etsuro Hatano
Iwao Ikai
Ryuichi Nishii
Yuji Nakamoto
Koichi Ishizu
Tsuyoshi Suga
Hidekazu Kawashima
Kaori Togashi
Satoru Seo
Koji Kitamura
Yasuji Takada
Shinji Kamimoto
Publication date
01-03-2010
Publisher
Springer-Verlag
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 3/2010
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-009-1284-9

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