[18F]FDG PET/MRI in the follow-up of hepatocellular carcinoma after liver transplantation

Abstract

Background There is limited evidence regarding the application of [18F] fluorodeoxyglucose (FDG)-PET/MRI in patients with a suspected clinical recurrence, who underwent liver transplantation for hepatocellular carcinoma (HCC). Therefore, we compared the accuracy of PET/MR and standard-of-care (SOC) imaging in these patients. Methods We retrospectively reviewed 26 patients, whose liver were transplanted for HCC and were suspected of disease relapse based on biochemical analysis or SOC follow-up imaging, and carried out PET/MRI with diffusion-weighted imaging sequences on them. All patients underwent SOC imaging within the 2 months prior to the PET/MRI examination and had follow-up data for at least 12 months after. Reference standards were histopathology, clinical and imaging follow-up data. Results Sensitivity, specificity, positive predictive value, negative predictive value and accuracy for PET/MRI were 100, 94, 91, 100 and 96%, whereas for SOC imaging were 80, 69, 61, 85 and 73%. The accuracy of PET/MRI was higher with respect to SOC imaging, although not significantly. Conclusions PET/MRI is useful for oncological surveillance of patients who have undergone liver transplantation for HCC, particularly in cases of allergy to contrast media, renal failure or persistently elevated alpha-fetoprotein levels, and with no identification of metastatic/relapsing foci at standard-of-care imaging.

Immunotherapy for transplantation of hepatocellular carcinoma: the next frontier in adjunctive therapy

“…They also demonstrated superior sensitivity in predicting treatment efficacy and correlating with tumor load when compared to AFP. Coupled with advancements in radiological imaging, such as the implementation of hybrid techniques like 18FDG PET/MRI, this could enable the early detection of high-risk patients or nonresponders [72,73].…”

Early prediction of the microvascular invasion (MVI) occurrence in hepatocellular carcinoma (HCC) by 18 F-FDG PET/CT and laboratory data

“…Based on this, 18 F-FDG PET has more important clinical signi cance for HCC screening and prognosis evaluation (11) . In view of the advantages of 18F-FDG PET/CT in evaluating tumor occurrence, stage, and prognosis (12,13) , we established a retrospective study to further explore the clinical application value of 18F-FDG PET/CT in predicting MVI of liver cancer. In this research, we evaluated the performance e ciency of 18F-FDG PET/CT imaging ndings and laboratory data for predicting the occurrence of MVI in patients with HCC to evaluate the value of surgery.…”