RT Journal Article
SR Electronic
T1 <strong><sup>18</sup></strong><strong>F-FDG PET/CT But Not Morphological Parameters Predict Survival after Yttrium-90 Transarterial Radioembolization in Unresectable Hepatocellular Carcinoma: an updated analysis. </strong>
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 534
OP 534
VO 58
IS supplement 1
A1 Jreige, Mario
A1 MITSAKIS, PERIKLIS
A1 Van Der Gucht, Axel
A1 Monteiro, Marina
A1 Gnesin, Silvano
A1 Nicod-Lalonde, Marie
A1 Duran, Rafael
A1 Prior, John
A1 Schaefer, Niklaus
YR 2017
UL http://jnm.snmjournals.org/content/58/supplement_1/534.abstract
AB 534Objectives: To investigate the role of pre-therapeutic anatomic versus functional imaging in predicting survival in patients undergoing transarterial radioembolization using Yttrium-90 (90Y-TARE) for unresectable HCC (uHCC).Methods: We analyzed data of 55 patients of our prospective database (48 men; median age, 68.1; range, 24 - 87 years) undergoing 90Y-TARE treatment for uHCC (37 resin, 18 glass). All patients underwent 18F-FDG PET/CT and CT and/or MRI scans as part of a pre-therapeutic work-up. Patients did not receive any treatment between these imaging procedures and 90Y-TARE. Prognostic value of 18F-FDG PET/CT metabolic parameters (SUVmax, tumor-to-liver [T/L] uptake ratio, SUVmean of healthy liver) and anatomic MRI or CT data (number and size of lesions, portal-venous infiltration [PVI]) was assessed by Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) and compared using the log-rank test. Furthermore the influence of relevant prognostic factors for HCC including Child-Pugh class, Barcelona Clinic Liver Cancer (BCLC) staging system, tumor size, PVI and serum AFP level compared to imaging on PFS and OS parameters was analyzed using COX multivariate analysis.Results: Median follow-up in living patients was 17.5 months (mo) (range, 1-50.1 mo). Relapse occurred in 39 patients (71%) at a median of 7.4 mo (range, 1.4-27.9 mo) after 90Y-TARE. Fourty patients (73%) died from their disease at a median of 7.7 mo (range, 2.2-35.2 mo) and relapse occurred in 28 (70%) of them. The prognostic markers were: i) the mean SUVmax lesion with a median PFS of 10.2 mo (95% CI 6.6-13.8 mo) in patients with a cutoff value &lt; 7.7 g/mL vs. 7.4 mo (95% CI 3-11.7 mo) in patients with a mean SUVmax lesion cutoff 蠅 7.7 g/mL (p=0.01) and ii) the T/L ratio with a median OS of 30.9 mo (95% CI 11.2-50.9 mo) in patients with a 1st quarter (Q1) cutoff value &lt; 2.0 vs. 8.9 mo (95% CI 7.4-10.4) in patients with a Q1 cutoff value 蠅 2 (p=0.02). In multivariable analysis, only the cutoff value of the mean SUVmax lesion and the Q1 T/L ratio were significant independent predictors of PFS (p=0.01) and OS (p=0.04) respectively when testing with either Child-Pugh class, the BCLC staging system and the serum AFP level.Conclusion: SUVmax lesion and T/L uptake ratio as assessed by 18F-FDG PET/CT, but not anatomic imaging were predictive markers of survival in patients undergoing 90Y-TARE for uHCC. Research Support: none