18F-FDG PET/CT predicts survival after 90Y transarterial radioembolization in unresectable hepatocellular carcinoma

Kim

et al. 2019

WJG

Hepatocellular carcinoma (HCC) is one of major causes of cancer mortality worldwide. For decades, 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) has been widely used for staging, predicting prognosis, and detecting cancer recurrence in various types of malignant diseases. Due to low sensitivity of FDG PET for detecting intrahepatic HCC lesions, the clinical value of FDG PET in HCC patients has been limited. However, recent studies with diverse analytic methods have shown that FDG PET has promising role in aiding management of HCC patients. In this review, we will discuss the clinical role of FDG PET for staging, predicting prognosis, and evaluating treatment response in HCC. Further, we will focus on recent clinical studies regarding implication of volumetric FDG PET parameters, the significance of FDG uptake in HCC for selecting treatment and predicting treatment response, and the use of radiomics of FDG PET in HCC.

Section: Fdg Uptake Of Hcc As a Predictor For Prognosismentioning

confidence: 99%

Emerging role of¹⁸F-fluorodeoxyglucose positron emission tomography for guiding management of hepatocellular carcinoma

Kim

et al. 2019

WJG

“…Accordingly, clinicians are interested in the ability of F‐FDG uptake in HCC to predict overall prognosis and response to TARE, as well as other treatments. Several studies have demonstrated that metabolic activity, assessed by PET/CT scan, can predict prognosis and treatment response including resection and external beam radiation therapy (EBRT) 24–26 . However, limited data are available regarding the predictive and prognostic values of FDG PET/CT after internal radiation treatments such as TARE.…”

Section: Discussionmentioning

confidence: 99%

Metabolic activity assessment by ¹⁸F‐fluorodeoxyglucose positron emission tomography in patients with hepatocellular carcinoma undergoing Yttrium‐90 transarterial radioembolization

Kim

J of Gastro and Hepatol

Kang

et al. 2021

Background and Aim 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a functional image technique that can inform clinical decisions related to prognosis. We investigated the predictive role of 18F‐fluorodeoxyglucose PET/CT in patients with hepatocellular carcinoma (HCC) undergoing Yttrium‐90 (Y‐90) transarterial radioembolization (TARE). Methods Patients with HCC treated with TARE and pre‐TARE PET/CT scan were recruited between 2009 and 2013. Maximum standardized uptake value and tumor‐to‐non‐tumorous liver uptake ratio (TLR) were measured. Tumor response was evaluated in accordance with modified RECIST criteria at 3‐month intervals after Y‐90 TARE. Results Forty patients were included in the final analysis. The median age was 56.5 years and male predominant. Disease control in treated lesion was achieved in 82.5% (n = 33) of patients. During median 18.3‐month follow‐up, 27.5% (n = 11) of patients achieved progression‐free survival. The cutoff of TLR, which was related to the median value, did not affect disease control rate, progression‐free survival, and overall survival in patients with Y‐90 TARE. Conclusions The TLR‐based stratification may be a simple method, but our study did not show the usefulness in predicting prognosis in HCC patients with Y‐90 TARE. Further studies with large number of patients are needed.

Journal of Clinical Interventional Radiology ISVIR

“…Recent studies have established the role of PET-CT in early prognostication and diagnosis of recurrent or residual disease in HCC. [56][57][58] A PET-based response assessment criteria known as Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST) has also been proposed. 59 However, 18F-fluorodeoxyglucose (18F-FDG) is not specific for HCC and there is lack of data on the standardized uptake value (SUV) in predicting survival.…”

Section: Positron Emission Tomography (Pet)-ctmentioning

confidence: 99%

Response Assessment Following Image-Guided Therapy of Hepatocellular Carcinoma

Gupta

Kalra

Gulati

et al. 2020

AbstractImage-guided locoregional therapies have an important role in the management of patients with hepatocellular carcinoma (HCC). Recent advances in the ablative as well as endovascular therapies have expanded the role of interventional radiologists in the treatment of HCC. Following image-guided therapy, an accurate response assessment is vital. Knowledge regarding normal postprocedure changes and subtle signs of residual or recurrent disease is important. In this review, we discuss various response evaluation criteria currently employed for HCC. We also discuss the postprocedure imaging features suggestive of residual disease or recurrence and imaging biomarkers for response assessment.