Original Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Jul 7, 2012; 18(25): 3215-3222
Published online Jul 7, 2012. doi: 10.3748/wjg.v18.i25.3215
Predictive value of 18F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma
Myeong Jun Song, Si Hyun Bae, Ie Ryung Yoo, Chung-Hwa Park, Jeong Won Jang, Ho Jong Chun, Byung Gil Choi, Hae Giu Lee, Jong Young Choi, Seung Kew Yoon
Myeong Jun Song, Si Hyun Bae, Chung-Hwa Park, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea
Ie Ryung Yoo, Department of Nuclear, Medicine College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea
Ho Jong Chun, Byung Gil Choi, Hae Giu Lee, Department of Radiology, College of Medicine, The Catholic University of Korea, Seoul 137-040, South Korea
Author contributions: Song MJ, Bae SH, Choi JY and Yoon SK designed the study and performed the data analysis; Yoo IR collected the data; Park CH, Jang JW wrote the manuscript; and Chun HJ, Choi BG, Lee HG contributed the treatment response clinical data.
Supported by National R and D Program grant for cancer control, Ministry of Health, Welfare and Family Affairs, South Korea, No. R0620390-1
Correspondence to: Si Hyun Bae, Professor, MD, PhD, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, No. 505 Banpodong, Seochogu, Seoul 137-040, South Korea. baesh@catholic.ac.kr
Telephone: +82-2-22582073 Fax: +82-2-34814025
Received: November 26, 2011
Revised: April 27, 2012
Accepted: May 26, 2012
Published online: July 7, 2012
Abstract

AIM: To investigate the correlation of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) with clinical features and the prediction of treatment response.

METHODS: A total of 83 hepatocellular carcinoma (HCC) patients undergoing 18F-FDG PET before transarterial chemolipiodolization with systemic chemo-infusion between October, 2006 and May, 2009 were retrospectively enrolled. The patients included 68 men and 15 women (mean age, 60 ± 10.7 years). The effect of 18F-FDG-monitored PET uptake on clinical features and on the evaluated treatment response was ascertained with modified Response Evaluation Criteria in Solid Tumors. The PET parameters of maximal standardized uptake value of the tumor (Tsuvmax), the ratio of the tumor maximal standardized uptake value (SUV) to the liver maximal SUV (Tsuvmax/Lsuvmax) and the ratio of tumor maximal SUV to the liver mean SUV (Tsuvmax/Lsuvmean) were tested as predictive factors.

RESULTS: Among the 3 SUV parameters, the Tsuvmax/Lsuvmean ratio (cutoff value of 1.90) was significantly associated with tumor burden including tumor size, tumor number, α-fetoprotein levels and tumor stage (P < 0.001, P = 0.008, P = 0.011, P < 0.001, respectively). The objective response rates in patients with a high SUV ratio (≥ 1.90) were significantly better than those with a low SUV ratio (< 1.90) (P = 0.020). The overall survival rates of patients exhibiting a low Tsuvmax/Lsuvmean ratio (< 1.90) and those with a high SUV ratio (≥ 1.90) was 38.2 and 10.3 mo, respectively (P < 0.01). However, the time to progression showed no significant difference between the groups (P = 0.15).

CONCLUSION: 18F-FDG PET can be an important predictor of HCC treatment. In particular, the Tsuvmax/Lsuvmean ratio (cutoff value of 1.90) can provide useful information in treatment prognosis for HCC patients treated with locoregional therapy.

Keywords: 18F-fluorodeoxyglucose positron emission tomography; Transarterial chemolipiodolization with systemic chemo-infusion; Treatment response; Predictive factor; Overall survival