18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma

Sugiyama, Masahiro; Sakahara, Harumi; Torizuka, Tatsuo; Kanno, Tatsuo; Nakamura, Fumitoshi; Futatsubashi, Masami; Nakamura, Satoshi

doi:10.1007/s00535-004-1427-5

Cited by 149 publications

(103 citation statements)

References 20 publications

(29 reference statements)

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“…HCCs accumulate FDG to varying degrees (only 55-65% of tumors give a positive result by PET scanning), limiting the sensitivity of PET for primary tumors [234,235]. However, FDG-PET seems to be a useful imaging modality for identifying extrahepatic metastases, although sensitivity is limited for lesions 1 cm or smaller [231,236]. …”

Section: Other Imaging Modalitiesmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Section: Other Imaging Modalitiesmentioning

confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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“…Due to the osteolytic nature of bone metastasis from HCC, the detectability of BS has been reported to be lower compared with cancers with osteoblastic metastasis [11][12][13]. Bony destruction resulting from osteolytic metastasis can present with photon defects in BS [14][15][16], but the correlation with 18 F-fluoro-2-deoxy-D-glucose (FDG) PET/ CT has not been explored.…”

Section: Introductionmentioning

confidence: 99%

“…However, several studies reported that PET or PET/CT is useful for detection of extrahepatic metastases from HCC [18][19][20][21]. Moreover, PET/CT showed higher sensitivity for the detection of bone metastasis than other extrahepatic metastases from HCC [22].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Seo

Choi

Kim

et al. 2011

Nucl Med Mol Imaging

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Purpose Bone metastasis from hepatocellular carcinoma (HCC) can present with soft tissue formation, resulting in oncologic emergency. Contrast-enhanced FDG PET/CT and bone scintigraphy were compared to evaluate characteristics of bone metastases with or without soft tissue formation from HCC. Methods Of 4,151 patients with HCC, 263 patients had bone metastases. Eighty-five patients with bone metastasis from HCC underwent contrast-enhanced FDG PET/CT. Fifty-four of the enrolled subjects had recent 99m Tc-HDP bone scintigraphy available for comparison. Metastatic bone lesions were identified with visual inspection on FDG PET/CT, and maximum standardized uptake value (SUV max ) was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology, combined imaging modalities, or serial follow-up studies. Results Forty-seven patients (55%) presented with soft tissue formation, while the remaining 38 patients presented without soft tissue formation. Frequent sites of bone metastases from HCC were the spine (39%), pelvis (19%), and rib cage (14%). The soft-tissue-formation group had more frequent bone pain (77 vs. 37%, p<0.0001), higher SUV max (6.02 vs. 3.52, p<0.007), and higher incidence of photon defect in bone scintigraphy (75 vs. 0%) compared to the non-soft-tissue-formation group. FDG PET/CT had higher detection rate for bone metastasis than bone scintigraphy both in lesion-based analysis (98 vs. 53%, p=0.0015) and in patient-based analysis (100 vs. 80%, p<0 .001). Conclusions Bone metastasis from HCC showed a high incidence of soft tissue formation requiring emergency treatment. Although the characteristic findings for soft tissue formation such as photon defect in bone scintigraphy are helpful in detection, overall detectability of bone metastasis is higher in FDG PET/CT. Contrast-enhanced PET/CT will be useful in finding and delineating softtissue-forming bone metastasis from HCC.

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“…[5][6][7] However, 18 F-FDG PET/CT is less suitable for the detection of primary HCC because of the variable 18 F-FDG uptake pattern in HCC. [8][9][10] However, 18 F-FDG PET/CT is known to be useful in the evaluation of extrahepatic metastases. 5,9,[11][12][13] Furthermore, pretransplant 18 F-FDG PET/CT has recently been shown to be able to predict a poor outcome after LT for patients with HCC.…”

mentioning

confidence: 99%

“…[8][9][10] However, 18 F-FDG PET/CT is known to be useful in the evaluation of extrahepatic metastases. 5,9,[11][12][13] Furthermore, pretransplant 18 F-FDG PET/CT has recently been shown to be able to predict a poor outcome after LT for patients with HCC. 14,15 Therefore, 18 F-FDG PET/ CT has been routinely applied to the assessment of patients with HCC before LT at some centers.…”

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confidence: 99%

Usefulness¹⁸F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients

et al. 2010

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F-fluoro-2-deoxy-D-glucose (18 F-FDG) positron emission tomography (PET)/computed tomography (CT) has recently been shown to be able to predict a poor outcome after liver transplantation (LT) for patients with hepatocellular carcinoma (HCC). However, there are few reports on the usefulness of PET during follow-up after LT. In this study, we assessed the efficacy of F-FDG PET/ CT during follow-up were included. The accuracy of 18 F-FDG PET/CT was assessed with imaging and histological studies. The most common sites of recurrence were extrahepatic (60%). The most common extrahepatic sites were the lungs and bone (31.3% each). Among 4 patients with intrahepatic recurrence, 1 patient (25%) was positive according to 18 F-FDG PET/CT. The detection rate of 18 F-FDG PET/CT was 92.9% for extrahepatic metastases ! 1 cm and 0% for lesions < 1 cm. The detection rate of 18 F-FDG PET/CT was 100% in bone and the lymph nodes, 60% in the lungs, and 0% in the brain. 18 F-FDG PET/CT identified 2 lesions in bone that were not found in a bone scan. In conclusion, because of its limitations for small lesions, intrahepatic lesions, and brain lesions, 18 F-FDG PET/CT is not suitable as a screening tool after LT. However, 18 F-FDG PET/CT could provide additional information beyond that provided by conventional modalities, and it could contribute to the clinical management of HCC recurrence after LT, especially in patients with extrahepatic recurrence. Liver Transpl 16:767-772,

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18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma

Abstract: This preliminary study suggested that 18F-FDG PET could provide additional information and contribute to the management of HCC patients suspected of having extrahepatic metastases.

Cited by 149 publications

References 20 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Usefulness¹⁸F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients

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18F-FDG PET in the detection of extrahepatic metastases from hepatocellular carcinoma

Abstract: This preliminary study suggested that 18F-FDG PET could provide additional information and contribute to the management of HCC patients suspected of having extrahepatic metastases.

Cited by 149 publications

References 20 publications

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CT and 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation

Usefulness18F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients

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Usefulness¹⁸F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients