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01.12.2014 | Original Article | Ausgabe 6/2014

International Journal of Clinical Oncology 6/2014

Clinical utility and limitations of FDG PET in detecting recurrent hepatocellular carcinoma in postoperative patients

Zeitschrift:
International Journal of Clinical Oncology > Ausgabe 6/2014
Autoren:
Nobuyuki Hayakawa, Yuji Nakamoto, Koya Nakatani, Etsuro Hatano, Satoru Seo, Tatsuya Higashi, Tsuneo Saga, Shinji Uemoto, Kaori Togashi

Abstract

Background

The clinical usefulness of positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) for the detection of recurrent hepatocellular carcinoma (HCC) is controversial because HCC displays varying FDG avidity. The purposes of this study were to re-evaluate the utility of FDG PET for the detection of recurrent HCC, and to assess its prognostic value in a large series of postoperative patients.

Methods

We retrospectively reviewed 113 scans in 86 patients undergoing FDG PET after curative surgery for HCC. These scans were performed for suspected recurrence on radiologic imaging (group A: n = 44) because of an elevated tumor marker level with negative prior imaging results (group B: n = 32) or with no suspicion of recurrence (group C: n = 37). FDG PET’s accuracy for recurrence detection and its value as a predictor of survival were assessed.

Results

The sensitivity, specificity, and diagnostic accuracy were 53, 100, and 55 % for group A; 34, 100, and 41 % for group B; and 11, 100, and 78 % for group C, respectively. A change in therapy resulted from the scan results in 7, 9, and 8 % in groups A, B, and C, respectively. The combined sensitivities for intra- and extrahepatic recurrence were 30 and 42 %, respectively. Histopathological features at initial surgery did not affect the sensitivity. The overall survival of patients with positive scans was significantly poorer than that of patients with negative scans (P = 0.008).

Conclusions

The sensitivity of FDG PET for recurrent HCC was low, with little change in treatment resulting. However, it can predict prognosis in postoperative patients.

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