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

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

An Erratum to this article was published on 17 November 2009

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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Authors and Affiliations

  1. Shiga Medical Center Research Institute, 5-4-30, Moriyama, Moriyama City, Shiga, 524-8524, Japan

    Tatsuya Higashi & Ryuichi Nishii

  2. Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Etsuro Hatano, Iwao Ikai, Satoru Seo, Koji Kitamura, Yasuji Takada & Shinji Kamimoto

  3. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Yuji Nakamoto, Koichi Ishizu, Tsuyoshi Suga, Hidekazu Kawashima & Kaori Togashi

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Correspondence to Tatsuya Higashi.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00259-009-1320-9

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Higashi, T., Hatano, E., Ikai, I. et al. FDG PET as a prognostic predictor in the early post-therapeutic evaluation for unresectable hepatocellular carcinoma. Eur J Nucl Med Mol Imaging 37, 468–482 (2010). https://doi.org/10.1007/s00259-009-1284-9

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