Preoperative PET-CT is useful for predicting recurrent extrahepatic metastasis of hepatocellular carcinoma after resection

Morio Kei

Kawaoka Tomokazu

Aikata Hiroshi

Namba Maiko

Uchikawa Shinsuke

Kodama Kenichiro

Ohya Kazuki

Fujino Hatsue

Nakahara Takashi

Murakami Eisuke

Yamauchi Masami

Tsuge Masataka

Hiramatsu Akira

Imamura Michio

Nakamura Yuko

Akagi Motonori

Awai Kazuo

Kobayashi Tsuyoshi

Ohdan Hideki

Chayama Kazuaki

European Journal of Radiology

Purpose
In recent years, it has been reported that use of 18F-FDG PET-CT can reveal the degree of hepatocellular carcinoma malignancy. We evaluate the ability of a preoperative 18F-FDG PET-CT to predict the recurrence of extrahepatic metastasis of HCC after surgery.

Methods
We retrospectively examined 67 patients who received 18F-FDG PET-CT prior to curative hepatic resection for HCC between April 2010 and March 2016. Multivariate Cox regression analysis was performed to identify the factors associated with recurrence of extrahepatic metastasis of HCC after surgery. We also evaluated the sensitivity, specifity, positive predictive value, negative predictive value and accuracy of diagnosis of 18F-FDG PET-CT for recurrent extrahepatic metastasis of HCC after surgery.

Results
The multivariate analysis identified a tumor-to-normal liver standardized uptake value ratio (TNR) ≥ 1.53 (hazard ratio [HR], 0.037; P = 0.003), multiple tumor nodules (HR, 0.121; P = 0.007), and presence of microvascular invasion (HR, 0.094; P = 0.003) as independent predictors of distant metastasis recurrence. A TNR ≥ 1.53 showed a sensitivity of 91.7 %, specificity of 76.4 %, positive predictive value of 45.8 %, negative predictive value of 97.7 %, and accuracy of 79.1 % for diagnosing distant metastasis recurrence of HCC. In a binomial logistic regression analysis of tumor factors associated with a TNR ≥ 1.53, poor tumor differentiation and large tumor size were significant factors.

Conclusion
18F-FDG PET-CT and microvascular invasion may be useful for predicting the recurrence of extrahepatic metastasis of HCC after surgery.

PET-CT

Hepatocellular cancer

Recurrence

Metastasis

eng

Elsevier

© 2020. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/

This is not the published version. Please cite only the published version. この論文は出版社版ではありません。引用の際には出版社版をご確認、ご利用ください。

[ISSN] 0720-048X

[DOI] 10.1016/j.ejrad.2020.108828

[PMID] 31955034

[DOI] https://doi.org/10.1016/j.ejrad.2020.108828