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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2019

01-07-2019 | Computed Tomography | Original Article

Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with combined hepatocellular-cholangiocarcinoma

Authors: Chae Hong Lim, Seung Hwan Moon, Young Seok Cho, Joon Young Choi, Kyung-Han Lee, Seung Hyup Hyun

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2019

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Abstract

Purpose

The prognostic value of pretreatment 18F-fluorodeoxyglucose positron emission tomography with computed tomography (FDG PET/CT) was assessed in patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC).

Methods

A total of 46 patients with cHCC-CC who underwent FDG PET/CT before treatment were retrospectively analysed. Tumour FDG avidity was measured in terms of the tumour-to-normal liver standardized uptake value ratio (TLR) of the primary tumour on FDG PET/CT. The prognostic significance of TLR using the median value of 3.4 as the cut-off value and other clinical variables was assessed using Cox proportional hazards regression models. Differences in progression-free survival (PFS) and overall survival (OS) in relation to TLR were examined by the Kaplan-Meier method.

Results

During a median follow-up period of 29 months, 29 patients (63.0%) showed tumour recurrence or progression, and 25 patients (54.4%) died from cancer. Higher TLRs (>3.4) were associated with larger tumour size (p = 0.007) and higher tumour stage (p = 0.030). In a univariable analysis, TLR, tumour stage and CEA were significant prognostic predictors. In a multivariable analysis, TLR was an independent predictor of PFS (HR 5.19, 95% CI 1.80–15.01; p = 0.002) and OS (HR 3.95, 95% CI 1.27–12.24; p = 0.017). Patients with a higher TLR showed significantly worse PFS (2-year survival rate 17.8% vs. 62.9%; p = 0.001) and OS (2-year survival rate, 39.1% vs. 77.3%; p = 0.001) than those with a lower TLR.

Conclusion

Pretreatment TLR of the primary tumour measured on FDG PET/CT is an independent predictor of survival in patients with cHCC-CC.
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Metadata
Title
Prognostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with combined hepatocellular-cholangiocarcinoma
Authors
Chae Hong Lim
Seung Hwan Moon
Young Seok Cho
Joon Young Choi
Kyung-Han Lee
Seung Hyup Hyun
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04327-2

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