Predictability of preoperative 18F-FDG PET for histopathological differentiation and early recurrence of primary malignant intrahepatic tumors.

Abstract

OBJECTIVE:

The limited studies with 18F-fluorodeoxyglucose (18F-FDG)-PET reported results and interpretations that differed between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHCC). We investigated the correlation between preoperative PET results and postoperative prognosis, including early (time-to-recurrence<6 months) tumor recurrence, and histopathological tumor differentiation in patients who had undergone surgery for primary malignant intrahepatic tumors, including HCC and IHCC.

MATERIALS AND METHODS:

We retrospectively reviewed 357 patients who had undergone curative surgery for malignant hepatic tumors, including primary HCC or IHCC, other than Klatskin tumors at a tertiary academic hospital between January 2005 and June 2012. All patients had undergone an 18F-FDG PET/computed tomography scan preoperatively and the maximum standardized uptake value of the tumor (max SUV tumor) and the tumor-to-nontumor SUV ratio (TNR) were calculated from 18F-FDG uptake. Histopathological differentiation grading was confirmed postoperatively.

RESULTS:

Among the patients, 115 cases with primary malignant intrahepatic tumors fulfilled the inclusion criteria. On univariate analysis, preoperative max SUV tumor and TNR showed a correlation with the overall and early tumor recurrence of HCC, but only max SUV tumor was associated with overall and early recurrence of IHCC (P<0.05). When considering postoperative histopathological differentiation, a correlation between max SUV tumor and TNR with HCC and between max SUV tumor and IHCC was found (P<0.05). However, on multivariate analysis, only early recurrence was associated with TNR in HCC and with max SUV tumor in IHCC.

CONCLUSION:

A preoperative 18F-FDG PET scan can be considered a useful reference for postoperative tumor recurrence and histopathological differentiation in cases of primary malignant intrahepatic tumors. 18F-FDG PET scan results should be interpreted separately for malignant liver tumors.

• Authors: Jeong-Yeop Song, Yun Nah Lee, Young Seok Kim, Sang Gyune Kim, Soo Ji Jin, Jung Mi Park, Gyu Seong Choi, Jun Chul Chung, Min Hee Lee, Youn Hee Cho, Moon Han Choi, Dong Choon Kim, Hyun Jong Choi, Jong Ho Moon, Se Hwan Lee, Seung Won Jeong, Jae Young Jang, Hong Soo Kim, Boo Sung Kim
• Journal: Nuclear medicine communications (Nucl Med Commun) Vol. 36 Issue 4 Pg. 319-27 (Apr 2015) ISSN: 1473-5628 [Electronic] England
• PMID: 25564069 (Publication Type: Journal Article)

Chemical References

• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Bile Duct Neoplasms (diagnostic imaging, pathology, surgery)
• Carcinoma, Hepatocellular (complications, diagnostic imaging, pathology, surgery)
• Cholangiocarcinoma (diagnostic imaging, pathology, surgery)
• Diagnosis, Differential
• Female
• Fluorodeoxyglucose F18
• Humans
• Liver Cirrhosis (complications)
• Liver Neoplasms (complications, diagnostic imaging, pathology, surgery)
• Male
• Middle Aged
• Multivariate Analysis
• Positron-Emission Tomography
• Preoperative Period
• Prognosis
• Recurrence
• Retrospective Studies