Cho Eunae, Jun Chung Hwan, Kim Ban Seok, Son Dong Jun, Choi Won Suk, Choi Sung Kyu
Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Turk J Gastroenterol. 2015 Jul;26(4):344-50. doi: 10.5152/tjg.2015.0152. Epub 2015 Jun 2.
BACKGROUND/AIMS: To elucidate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) imaging as an independent prognostic factor in hepatocellular carcinoma (HCC).
A total of 104 patients with newly diagnosed HCC who underwent 18F-FDG-PET/CT imaging from 2009 to 2014 were reviewed retrospectively. The ratio of the maximal tumor standardized uptake value (SUV) to the mean mediastinum SUV (TSUVmax/MSUVmean) was evaluated as the predictive factor.
A high TSUVmax/MSUVmean ratio (≥3.1) was significantly associated with tumor burden indices, including α-fetoprotein (p<0.001), amino transaminase (AST) (p=0.007), tumor size (p=0.043), Tumor, Node, and Metastasis (TNM) stage (p<0.001), and Barcelona Clinic Liver Cancer (BCLC) staging (p<0.001). The mortality rate was higher (48.1% vs. 23.1%, p<0.001) in patients with a high TSUVmax/MSUVmean ratio (≥3.1). Among the 47 patients who underwent transarterial chemoembolization (TACE), patients with a high TSUVmax/MSUVmean ratio (≥3.1) were more likely to have recurrence following TACE (18/19 vs. 18/28, p=0.016).
A high TSUVmax/MSUVmean ratio on 18F-FDG-PET/CT imaging can serve as an independent prognostic factor in HCC and may predict tumor recurrence after TACE.
背景/目的：阐明18F-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG-PET/CT）成像作为肝细胞癌（HCC）独立预后因素的作用。
回顾性分析2009年至2014年期间104例新诊断的HCC患者，这些患者均接受了18F-FDG-PET/CT成像检查。将最大肿瘤标准化摄取值（SUV）与平均纵隔SUV的比值（TSUVmax/MSUVmean）作为预测因子进行评估。
高TSUVmax/MSUVmean比值（≥3.1）与肿瘤负荷指标显著相关，包括甲胎蛋白（p<0.001）、氨基转移酶（AST）（p=0.007）、肿瘤大小（p=0.043）、肿瘤、淋巴结转移（TNM）分期（p<0.001）以及巴塞罗那临床肝癌（BCLC）分期（p<0.001）。高TSUVmax/MSUVmean比值（≥3.1）的患者死亡率更高（48.1%对23.1%，p<0.001）。在47例行经动脉化疗栓塞术（TACE）的患者中，高TSUVmax/MSUVmean比值（≥3.1）的患者TACE术后更易复发（18/19对18/28，p=0.016）。
18F-FDG-PET/CT成像上的高TSUVmax/MSUVmean比值可作为HCC的独立预后因素，并可能预测TACE术后肿瘤复发。
