Glucose metabolism in cirrhosis: A review with some perspectives for the future

Petrides, Alexander S.; DeFronzo, Ralph A.

doi:10.1002/dmr.5610050805

Cited by 122 publications

(71 citation statements)

References 118 publications

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“…Uptake of 18 F-FDG in HCC is well known to vary with the expression of glucose-6-phosphatase (25). Moreover, most patients who have HCC accompanied by viral infection have underlying liver cirrhosis, which affects glucose metabolism (26), blood glucose level, and tumor uptake of 18 F-FDG. Therefore, the tumor-to-liver ratio of SUV is a more commonly used diagnostic factor than is SUV in 18 F-FDG PET of HCC patients, as the ratio reflects the underlying variation of glucose metabolism in the liver.…”

Section: Discussionmentioning

confidence: 99%

Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Lee¹,

Paeng²,

Kang³

et al. 2009

J Nucl Med

155

125

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Although several prognostic factors are used to predict recurrence and to select adequate candidates for liver transplantation for hepatocellular carcinoma (HCC), these prognostic factors have some clinical limitations. The purpose of this study was to evaluate 18 F-FDG PET as a prognostic factor and to optimize its ability to predict tumor recurrence in liver transplantation for HCC. Methods: The study included a total of 59 HCC patients (45 men and 15 women; mean age 6 SD, 56 6 8 y) who underwent 18 F-FDG PET and subsequent orthotopic liver transplantation. All patients were followed up for more than 1 y (mean, 29 6 17 mo), and recurrence of tumor was monitored. Three PET parameters-maximal standardized uptake value (SUV max ), ratio of tumor SUV max to normal-liver SUV max (T SUVmax /L SUVmax ), and ratio of tumor SUV max to normal-liver mean SUV (T SUVmax / L SUVmean )-were tested as prognostic factors and compared with conventional prognostic factors. Results: Among the 3 parameters tested, T SUVmax /L SUVmax was the most significant in the prediction of tumor recurrence, with a cutoff value of 1.15. In a multivariate analysis of various prognostic factors including T SUVmax /L SUVmax , serum a-fetoprotein, T stage, size of tumor, and vascular invasion of tumor, T SUVmax /L SUVmax was the most significant, and only vascular invasion of tumor had additional significance. According to T SUVmax /L SUVmax , the 1-y recurrencefree survival rate above the cutoff was markedly different from the rate below the cutoff (97% vs. 57%, P , 0.001). Conclusion: In this study, 18 F-FDG PET was an independent and significant predictor of tumor recurrence. In liver transplantation for HCC, 18 F-FDG PET can provide effective information on the prognosis for tumor recurrence and the selection of adequate candidates for liver transplantation.

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Section: Discussionmentioning

confidence: 99%

Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Lee¹,

Paeng²,

Kang³

et al. 2009

J Nucl Med

155

125

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“…However, most patients with HCC have underlying liver cirrhosis or chronic hepatitis and ~20%−56% of patients even have previously undiagnosed liver cirrhosis (25,26). Because 18 F-FDG uptake is altered by underlying liver cirrhosis or chronic liver disease, background liver SUV can also be affected, and sometimes increased uptake of the liver tumor may even be concealed by background liver cirrhosis (27,28). In addition, many patients have diffuse, multinodular, or massive HCCs (29), making it difficult to obtain background liver SUV because of the small remnant non-tumor liver volume available.…”

Section: F-fdg Pet Ct In Hccmentioning

confidence: 99%

18F-FDG PET CT as a prognostic factor in hepatocellular carcinoma

Cho

Jun²,

Kim³

et al. 2015

Turk J Gastroenterol

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“…9 Insulin resistance is common in cirrhosis and is the principal pathophysiologic basis for so-called hepatogenous diabetes. Of course, some cirrhotic patients may have diabetes that is independent of their liver disease.…”

Section: Pathogenesis and Prevalence Of Diabetes In Liver Transplant mentioning

confidence: 99%

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

Reuben

2001

Liver Transplantation

115

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Key Points 1. As long-term survival improves after liver transplantation, cardiovascular complications are emerging as a major cause of late morbidity and mortality. It seems reasonable to correct the potentially reversible cardiovascular risk factors of diabetes, hyperlipidemia, and obesity, in addition to hypertension. 2. The results of liver transplantation in diabetics are acceptable in terms of morbidity, mortality, and prevalence of posttransplant diabetes, but the poor outcomes described in some series suggest that more extensive testing for macro-and microvascular disease may become necessary. T he main aim of liver transplantation, besides the immediate goal of saving life, is to return the patient to productive community living with good quality of life. It is ironic, therefore, that many of the health problems that afflict successful liver transplant recipients long term are those of community living in the developed world, including diabetes mellitus, hyperlipidemia, and obesity. These three metabolic derangements, together with hypertension, constitute adverse cardiovascular risk factors for transplant recipients. The management of diabetes in liver transplant recipients is not substantially different from its management in

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Glucose metabolism in cirrhosis: A review with some perspectives for the future

Cited by 122 publications

References 118 publications

Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

18F-FDG PET CT as a prognostic factor in hepatocellular carcinoma

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

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Glucose metabolism in cirrhosis: A review with some perspectives for the future

Cited by 122 publications

References 118 publications

Prediction of Tumor Recurrence by 18F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Prediction of Tumor Recurrence by 18F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

18F-FDG PET CT as a prognostic factor in hepatocellular carcinoma

Long-term management of the liver transplant patient: Diabetes, hyperlipidemia, and obesity

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Product

Resources

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Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma

Prediction of Tumor Recurrence by ¹⁸F-FDG PET in Liver Transplantation for Hepatocellular Carcinoma