18F-FDG PET/CT predicts microvascular invasion and early recurrence after liver resection for hepatocellular carcinoma

Lim, Chetana; Salloum, Chady; Chalaye, Julia; Lahat, Eylon; Costentin, Charlotte; Osseis, Michael; Itti, Emmanuel; Féray, Cyrille; Azoulay, Daniel

doi:10.1016/j.hpb.2018.10.007

Cited by 45 publications

(36 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…( 22 ) High‐grade [ 18 F]FDG avidity may not only signal a change in metabolome but could also identify a more aggressive and invasive phenotype with a higher risk of microvascular invasion and metastatic disease. ( 8,9 ) For example, Kwee et al correlated high tumor [ 18 F]‐fluorocholine uptake with specific gene signatures and increased mortality. ( 23 ) Although prior studies have shown that PET‐CT positivity is associated with microvascular invasion and recurrence risk after surgical resection ( 9 ) and liver transplantation, ( 12 ) we did not have the sample size of patients in these subgroups to corroborate this finding.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Addition of [18F]Fluorodeoxyglucose Positron Emission Tomography With Computed Tomography to Cross‐Sectional Imaging Improves Staging and Alters Management in Hepatocellular Carcinoma

et al. 2020

View full text Add to dashboard Cite

In this work, we characterize the value of positron emission tomography (PET) with computed tomography (CT) in combination with cross-sectional imaging for staging and prognostication of hepatocellular carcinoma (HCC) patients. In this retrospective cohort study, HCC patients underwent PET-CT after initial staging with contrast-enhanced CT or magnetic resonance imaging (MRI). The benefit of PET-CT was measured by the identification of new HCC lesions, and potential harm was quantified by the number of false positives and subsequent diagnostic evaluation. We used multivariate Cox regression analysis to evaluate the association between the highest grade on PET-CT with the risk of extrahepatic metastasis, progression-free, and overall survival. Among 148 patients, PET-CT detected additional extrahepatic metastasis in 11.9% of treatment-naïve and 13.8% of treatmentexperienced patients. PET-CT changed the Barcelona Clinic Liver Cancer (BCLC) staging in 5.9% of treatment-naïve and 18.8% of treatment-experienced patients compared with CT/MRI alone, changing HCC management in 9.9% and 21.3% of patients, respectively. Of the patients, 5% (n = 8) experienced severe physical harm requiring additional procedures to evaluate extrahepatic findings. High tumor grade on PET-CT was independently associated with a higher likelihood of extrahepatic metastasis (hazard ratio [HR], 17.1; 95% confidence interval [CI], 3.6-81.5) and worse overall survival (HR, 2.4; 95% CI, 1.4-4.3). Treatment-experienced patients (versus treatment-naïve patients; HR, 9.7; 95% CI, 1.9-49.4) and BCLC stage A (HR, 8.2; 95% CI, 1.5-45.9; P < 0.01) and BCLC stage B (HR, 20.6; 95% CI, 1.5-282.2; P < 0.05) were more likely to have an upstaging with PET-CT compared with BCLC stage C (reference). PET-CT provides prognostic information and improves tumor staging beyond CT/MRI alone, with subsequent changes in management for patients with HCC.Liver Transplantation 26 774-784 2020 AASLD.

show abstract

Section: Discussionmentioning

confidence: 99%

“…( 6 ) However, data from Europe and Asia are beginning to suggest that PET‐CT may have a role in the staging and management of HCC including early detection of disease recurrence following resection as well as identification of occult intrahepatic and extrahepatic metastasis or vascular invasion. ( 7‐13 )…”

mentioning

confidence: 99%

Addition of [18F]Fluorodeoxyglucose Positron Emission Tomography With Computed Tomography to Cross‐Sectional Imaging Improves Staging and Alters Management in Hepatocellular Carcinoma

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Hyun et al reported that higher TLR (≥2) was significantly associated with death in patients underwent curative treatments including resection, liver transplantation, and radiofrequency ablation [24]. Lim et al showed that visual positivity of 18 F-FDG-PET was an independent predictor for early recurrence after liver resection in their prospective observation study [25]. In the present study, visual qualitative analysis was used to evaluate 18 F-FDG uptake because in clinical practice, visual analysis is easier than quantitative analysis.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2020

View full text Add to dashboard Cite

Background 18F-fluorodeoxyglucose (18F-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 18F-FDG uptake and outcomes after radiofrequency ablation (RFA). A prospective cohort study was conducted to evaluate the prognostic value of 18F-FDG positron emission tomography (PET) in HCC patients after RFA. Methods A total of 121 consecutive patients with primary HCC (≤3 tumors, of diameter ≤ 3 cm) without vascular invasion on imaging were examined by 18F-FDG-PET computed tomography prior to RFA. An HCC with a component of 18F-FDG uptake visibly stronger than that of surrounding liver was defined as 18F-FDG-PET positive. Results The median follow-up period was 1267 days. There were 110 18F-FDG-PET negative and 11 positive tumors. The cumulative 1-year recurrence rates in the 18F-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 18F-FDG-PET positivity and tumor size as independent factors related to metastatic recurrence and survival after RFA. Conclusions 18F-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 18F-FDG uptake.

show abstract

“…The 18 F-FDG uptake of HCC is variable; K19-positive HCC is associated with high 18 F-FDG uptake. In addition, high 18 F-FDG uptake in HCC has been associated with poor differentiation, microvascular invasion, advanced tumor stage, and a poor outcome after surgical resection or transplantation [97][98][99]. In an in vitro study, the K19-positive tumor cell subpopulation displayed higher 18 F-FDG uptake than the K19-negative subpopulation, and K19 expression was found to increase 18 F-FDG uptake through TGF-β/Smad signaling and the subsequent upregulation of the glucose transporter GLUT1 [83].…”

Section: High Uptake Of 18 F-fdgmentioning

confidence: 99%

Clinico-Radio-Pathological and Molecular Features of Hepatocellular Carcinomas with Keratin 19 Expression

Rhee¹,

Kim²,

Park³

2020

Liver Cancer

View full text Add to dashboard Cite

Hepatocellular carcinoma (HCC) is a heterogeneous neoplasm, both from the molecular and histomorphological aspects. One example of heterogeneity is the expression of keratin 19 (K19) in a subset (4–28%) of HCCs. The presence of K19 expression in HCCs has important clinical implications, as K19-positive HCCs have been associated with aggressive tumor biology and poor prognosis. Histomorphologically, K19-positive HCCs demonstrate a more infiltrative appearance, poor histological differentiation, more frequent vascular invasion, and more intratumoral fibrous stroma than K19-negative conventional HCCs. From the molecular aspect, K19-positive HCCs have been matched with various gene signatures that have been associated with stemness and poor prognosis, including the G1–3 groups, S2 class, cluster A, proliferation signature, and vascular invasion signature. K19-positive HCCs also show upregulated signatures related to transforming growth factor-β pathway and epithelial-to-mesenchymal transition. The main regulators of K19 expression include hepatocyte growth factor-MET paracrine signaling by cancer-associated fibroblast, epidermal growth factor-epidermal growth factor receptor signaling, laminin, and DNA methylation. Clinically, higher serum alpha-fetoprotein levels, frequent association with chronic hepatitis B, more invasive growth, and lymph node metastasis have been shown to be characteristics of K19-positive HCCs. Radiologic features including atypical enhancement patterns, absence of tumor capsules, and irregular tumor margins can be a clue for K19-positive HCCs. From a therapeutic standpoint, K19-positive HCCs have been associated with poor outcomes after curative resection or liver transplantation, and resistance to systemic chemotherapy and locoregional treatment, including transarterial chemoembolization and radiofrequency ablation. In this review, we summarize the currently available knowledge on the clinico-radio-pathological and molecular features of K19-expressing HCCs, including a detailed discussion on the regulation mechanism of these tumors.

show abstract

18F-FDG PET/CT predicts microvascular invasion and early recurrence after liver resection for hepatocellular carcinoma

Cited by 45 publications

References 51 publications

Addition of [18F]Fluorodeoxyglucose Positron Emission Tomography With Computed Tomography to Cross‐Sectional Imaging Improves Staging and Alters Management in Hepatocellular Carcinoma

Addition of [18F]Fluorodeoxyglucose Positron Emission Tomography With Computed Tomography to Cross‐Sectional Imaging Improves Staging and Alters Management in Hepatocellular Carcinoma

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

Clinico-Radio-Pathological and Molecular Features of Hepatocellular Carcinomas with Keratin 19 Expression

Contact Info

Product

Resources

About