Tumor FDG avidity measured by TLR on FDG PET/CT is a preoperative imaging biomarker for the prediction of MVI in patients with HCC.

Pseudocirrhosis refers to a condition that shows changes in hepatic contour that mimic cirrhosis radiographically in the absence of the typical histopathological findings of cirrhosis. This condition has been observed in patients with cancer metastatic to the liver, both in those who have undergone prior systemic chemotherapy and those who have not. Pseudocirrhosis may cause difficulty in interpretation of the response to chemotherapy and hepatic decompression and complication of portal hypertension have a negative effect on the prognosis. We report on a case of breast cancer with liver metastases that showed cirrhotic changes during disease progression. Progression of liver metastases was confirmed by F18 fluorodeoxyglucose positron emission tomography/computed tomography (PET-CT). We also performed ultrasound-guided liver biopsy and confirmed tumor infiltration with severe desmoplastic fibrosis. This case suggests the pathogenesis of pseudocirrhosis through histopathological findings and the role of PET-CT in evaluation of the response to chemotherapy in patients with pseudocirrhosis.

Background: To compare the diagnostic sensitivity of [ 18 F]fluoroestradiol ([ 18 F]FES) and [ 18 F]fluorodeoxyglucose ([ 18 F]FDG) positron emission tomography/computed tomography (PET/CT) for breast cancer recurrence in patients with estrogen receptor (ER)-positive primary breast cancer. Methods: Our database of consecutive patients enrolled in a previous prospective cohort study to assess [ 18 F]FES PET/CT was reviewed to identify eligible patients who had ER-positive primary breast cancer with suspected first recurrence at presentation and who underwent [ 18 F]FDG PET/CT. The sensitivity of qualitative [ 18 F]FES and [ 18 F]FDG PET/CT interpretations was assessed, comparing them with histological diagnoses. Results: Of the 46 enrolled patients, 45 were confirmed as having recurrent breast cancer, while one was diagnosed with chronic granulomatous inflammation. Forty (89%) patients were ER-positive, four (9%) were ER-negative, and one (2%) patient did not undergo an ER assay. The sensitivity of [ 18 F]FES PET/CT was 71.1% (32/45, 95% CI, 55.7-83.6), while that of [ 18 F]FDG PET/CT was 80.0% (36/45, 95% CI, 65.4-90.4) with a threshold of positive interpretation, and 93.3% (42/ 45, 95% CI, 81.7-98.6) when a threshold of equivocal was used. There was no significant difference in sensitivity between [ 18 F]FES and [ 18 F]FDG PET/CT (P = 0.48) with a threshold of positive [ 18 F]FDG uptake, but the sensitivity of [ 18 F]FDG was significantly higher than [ 18 F]FES (P = 0.013) with a threshold of equivocal [ 18 F]FDG uptake. One patient with a benign lesion showed negative [ 18 F]FES but positive [ 18 F]FDG uptake.

SUVmax from both early and delayed PET/CT scans are useful parameters in the differentiation of extrahepatic biliary malignancy from benign disease. However, there was no added benefit of delayed PET/CT in patients suspicious for extrahepatic cholangiocarcinoma.

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Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) consists of a heterogeneous group of patients with a wide range of survival times, requiring further prognostic stratification to facilitate treatment allocation. We evaluated the prognostic value of F-FDG uptake on PET/CT at the time of presentation in patients with BCLC stage C HCC. A total of 291 patients with BCLC stage C HCC who underwent F-FDG PET/CT between 2009 and 2010 for staging were retrospectively enrolled from 7 university hospitals. The patients were further divided into 2 groups according to the extent of disease, as intrahepatic or extrahepatic. Tumor-to-liver SUV ratio (TLR) of the primary tumor was measured onF-FDG PET/CT. Prognostic values of TLR and other clinical variables were analyzed to predict overall survival (OS) in univariate and multivariate analyses. Differences in the OS stratified by TLR were examined by the Kaplan-Meier method. Higher TLR was associated with extrahepatic disease ( = 0.018). On multivariate analysis, Child-Pugh classification and TLR were independent prognostic factors in the intrahepatic disease group (all < 0.05), whereas TLR was the only independent prognostic factor in the extrahepatic disease group ( < 0.05). Patients with high TLR showed a significantly worse OS than those with low TLR ( < 0.05) in both groups. In patients with BCLC stage C HCC,F-FDG uptake in the primary tumor was significantly higher in patients with extrahepatic disease than in those with intrahepatic disease. In addition, F-FDG uptake on pretreatment PET/CT had an incremental prognostic value for OS in both intrahepatic and extrahepatic disease groups.

Diagnostic accuracy of FDG PET in radioiodine negative thyroid cancer may vary depending on serum Tg levels at imaging. (18)F-FDG PET/CT is useful in detection and localization of recurrent thyroid cancer in patients with negative diagnostic radioiodine scan despite elevated Tg greater than 20 ng/ml or high anti-Tg Ab titers. In contrast, PET/CT provides little additional information when the Tg is less than 5 ng/ml.

Single-photon emission computed tomography/CT combined with Tc-HMPAO-labeled leukocyte imaging was useful for diagnosing prosthesis infections, particularly in hip prosthesis infections, as it improved diagnostic accuracy and provided anatomical localization data.