Prognostic value of 18 F-fluorodeoxyglucose positron emission tomography in patients with small hepatocellular carcinoma treated by radiofrequency ablation

• Published in: Cancer imaging Vol. 20; no. 1; p. 74
• Main Authors: Ida, Yoshiyuki, Tamai, Hideyuki, Shingaki, Naoki, Shimizu, Ryo, Maeshima, Shuya, Maekita, Takao, Iguchi, Mikitaka, Terada, Masaki, Kitano, Masayuki
• Format: Journal Article
• Language: English
• Published: England 19-10-2020
• Subjects: Adult; Aged; Carcinoma, Hepatocellular - diagnostic imaging; Carcinoma, Hepatocellular - radiotherapy; Female; Fluorodeoxyglucose F18; Humans; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - therapy; Male; Middle Aged; Positron-Emission Tomography - methods; Positron-Emission Tomography - standards; Predictive Value of Tests; Radiofrequency Ablation; Radiopharmaceuticals; 18F-fluorodeoxyglucose positron emission tomography; Radiofrequency ablation; Hepatocellular carcinoma
• ISSN: 1470-7330

F-fluorodeoxyglucose (
F-FDG) uptake in hepatocellular carcinoma (HCC) is significantly associated with early recurrence and survival after curative surgical resection. However, there are no reports regarding the relationship between
F-FDG uptake and outcomes after radiofrequency ablation (RFA). A prospective cohort study was conducted to evaluate the prognostic value of
F-FDG positron emission tomography (PET) in HCC patients after RFA.
A total of 121 consecutive patients with primary HCC (≤3 tumors, of diameter ≤ 3 cm) without vascular invasion on imaging were examined by
F-FDG-PET computed tomography prior to RFA. An HCC with a component of
F-FDG uptake visibly stronger than that of surrounding liver was defined as
F-FDG-PET positive.
The median follow-up period was 1267 days. There were 110
F-FDG-PET negative and 11 positive tumors. The cumulative 1-year recurrence rates in the
F-FDG negative and positive groups were 30 and 64% (P = 0.017), respectively, and cumulative 1-year metastatic recurrence rates were 6 and 36% (P < 0.001), respectively. The cumulative 5-year survival rates were 88 and 22% (P < 0.001), respectively. Multivariate analysis revealed
F-FDG-PET positivity and tumor size as independent factors related to metastatic recurrence and survival after RFA.
F-FDG-PET positivity was significantly associated with outcomes after RFA. RFA should not be readily selected as the first-line treatment for small HCC that includes a component of visually strong
F-FDG uptake.