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Efficiency of whole-body 18F-FDG PET CT in detecting the cause of rising serum AFP level in post-therapeutic follow-up for HCC patients

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Abstract

Purpose

The goal of this study was to assess the value of whole-body 18F-FDG PET/CT in detecting the cause of rising serum alpha-fetoprotein (AFP) level after the treatment of hepatocellular carcinoma (HCC).

Materials and methods

18F-FDG PET/CT studies were performed for 100 patients (76 men and 24 women), ranged in age from 40 to 76 years who had underwent either surgical resection or interventional therapy for HCC, but were subsequently noted to have rising AFP serum level on routine follow-up examinations. The 18F-FDG PET/CT results were correlated with histological findings or radiological and clinical follow-up.

Results

According to patient-based analysis, 18F-FDG PET/CT demonstrated 74 true-positives, four false-negatives, 16 true-negative, and 6 false-positive results, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 95%, 72.7%, 92.5%, 80%, and 90%, respectively. According to Lesion-based analysis, 18F-FDG PET/CT demonstrated 202 true-positive lesions, 8 false-negatives, and 16 true-negative and 6 false-positive results, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 98%, 72.7%, 97%, 80%, and 95.6%, respectively.

Conclusion

18F-FDG PET/CT is a valuable imaging tool investigating patients who have a rising serum AFP level after HCC treatment. It accurately detects residual or recurrent tumor as well as extrahepatic metastasis.

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Authors and Affiliations

  1. Radiodiagnosis Department, Ain Shams University, Cairo, Egypt

    Susan Adil Ali & Yasser Ibrahim Abdelkhalek

  2. Anthropology Biology Department, National Research Center, Cairo, Egypt

    Darine Helmy Amin

Authors
  1. Susan Adil Ali
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  2. Darine Helmy Amin
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  3. Yasser Ibrahim Abdelkhalek
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by SAA, DHA, and YIAE. The first draft of the manuscript was written by SAA and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Susan Adil Ali.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Ali, S.A., Amin, D.H. & Abdelkhalek, Y.I. Efficiency of whole-body 18F-FDG PET CT in detecting the cause of rising serum AFP level in post-therapeutic follow-up for HCC patients. Jpn J Radiol 38, 472–479 (2020). https://doi.org/10.1007/s11604-020-00930-8

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