RT Journal Article SR Electronic T1 Prediction of Tumor Recurrence by 18F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP 682 OP 687 DO 10.2967/jnumed.108.060574 VO 50 IS 5 A1 Lee, Jeong Won A1 Paeng, Jin Chul A1 Kang, Keon Wook A1 Kwon, Hyun Woo A1 Suh, Kyung-Suk A1 Chung, June-Key A1 Lee, Myung Chul A1 Lee, Dong Soo YR 2009 UL http://jnm.snmjournals.org/content/50/5/682.abstract AB Although several prognostic factors are used to predict recurrence and to select adequate candidates for liver transplantation for hepatocellular carcinoma (HCC), these prognostic factors have some clinical limitations. The purpose of this study was to evaluate 18F-FDG PET as a prognostic factor and to optimize its ability to predict tumor recurrence in liver transplantation for HCC. Methods: The study included a total of 59 HCC patients (45 men and 15 women; mean age ± SD, 56 ± 8 y) who underwent 18F-FDG PET and subsequent orthotopic liver transplantation. All patients were followed up for more than 1 y (mean, 29 ± 17 mo), and recurrence of tumor was monitored. Three PET parameters—maximal standardized uptake value (SUVmax), ratio of tumor SUVmax to normal-liver SUVmax (TSUVmax/LSUVmax), and ratio of tumor SUVmax to normal-liver mean SUV (TSUVmax/LSUVmean)—were tested as prognostic factors and compared with conventional prognostic factors. Results: Among the 3 parameters tested, TSUVmax/LSUVmax was the most significant in the prediction of tumor recurrence, with a cutoff value of 1.15. In a multivariate analysis of various prognostic factors including TSUVmax/LSUVmax, serum α-fetoprotein, T stage, size of tumor, and vascular invasion of tumor, TSUVmax/LSUVmax was the most significant, and only vascular invasion of tumor had additional significance. According to TSUVmax/LSUVmax, the 1-y recurrence-free survival rate above the cutoff was markedly different from the rate below the cutoff (97% vs. 57%, P < 0.001). Conclusion: In this study, 18F-FDG PET was an independent and significant predictor of tumor recurrence. In liver transplantation for HCC, 18F-FDG PET can provide effective information on the prognosis for tumor recurrence and the selection of adequate candidates for liver transplantation.