Impact of positron emission tomography on strategy in liver resection for primary and secondary liver tumors

Böhm, B.; Voth, M.; Geoghegan, Justin; Hellfritzsch, H.; Petrovich, A.; Scheele, J.; Gottschild, D

doi:10.1007/s00432-003-0527-6

Cited by 81 publications

(54 citation statements)

References 46 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…FDG PET/CT has been known to be less suitable for primary HCC due to limited detectability [17]. However, several studies reported that PET or PET/CT is useful for detection of extrahepatic metastases from HCC [18][19][20][21].…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…However, the high level of glucose-6-phosphatase in liver tissue leads to the release of FDG-6-phosphate, resulting in reduced accumulation in differentiated HCCs (6). Thus, 18 F-FDG PET has an average false-negative rate of 40%250% for the detection of HCC (7), and data on the role of PET/CT in the detection of HCC metastasis are limited (7)(8)(9). 11 C-labeled acetate PET effectively detects urologic malignancies (10).…”

mentioning

confidence: 99%

“…PET/CT is used mainly to screen for tumor metastasis, and its use is increasing because of an increasing number of candidates for curative treatment such as liver transplantation. Previous studies of PET/CT in patients with primary and metastatic HCC enrolled few patients or were retrospective (7)(8)(9)11,12).…”

mentioning

confidence: 99%

A Prospective Evaluation of¹⁸F-FDG and¹¹C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma

Park¹,

Kim²,

Kim³

et al. 2008

J Nucl Med

252

237

View full text Add to dashboard Cite

Because 18 F-FDG PET has insufficient sensitivity for the detection of hepatocellular carcinoma (HCC), 11 C-acetate PET has been proposed as another technique for this use. We prospectively evaluated the value of PET/CT using these 2 tracers for the detection of primary and metastatic HCC. Methods: One hundred twelve patients (99 with HCC, 13 with cholangiocellular carcinoma) underwent biopsy and 18 F-FDG and 11 C-acetate PET/CT. Results: The overall sensitivities of 18 F-FDG, 11 C-acetate, and dual-tracer PET/CT in the detection of 110 lesions in 90 patients with primary HCC were 60.9%, 75.4%, and 82.7%, respectively. Elevated serum a-fetoprotein levels, an advanced tumor stage, portal vein tumor thrombosis, large tumors, and multiple tumors were significantly associated with positive 18 F-FDG PET/CT results. Uptake of 11 C-acetate was associated with large and multiple tumors. For 18 F-FDG, the sensitivities according to tumor size (1-2, 2-5, and $5 cm) were 27.2%, 47.8%, and 92.8%, respectively; for 11 C-acetate, these respective values were 31.8%, 78.2%, and 95.2%. 18 F-FDG was more sensitive in the detection of poorly differentiated HCC. Overall survival was lower in patients with 18 F-FDG PET/CT positive for all indexed lesions than in those with FDG negative or partially positive through the entire follow-up period. In analysis based on biopsied lesions, the sensitivity of 18 F-FDG PET/CT was 64.4% for primary HCC and 84.4% for 11 C-acetate PET/CT. The overall sensitivities of 18 F-FDG, 11 C-acetate, and dual-tracer PET/CT for 35 metastatic HCCs were 85.7%, 77.0%, and 85.7%, respectively. There was no significant difference in the sensitivity of tracers according to metastatic tumor size, location, or differentiation. Conclusion: The addition of 11 C-acetate to 18 F-FDG PET/CT increases the overall sensitivity for the detection of primary HCC but not for the detection of extrahepatic metastases. 18 F-FDG, 11 C-acetate, and dual-tracer PET/CT have a low sensitivity for the detection of small primary HCC, but 18 F-FDG PET/CT has a relatively high sensitivity for the detection of extrahepatic metastases of HCC.

show abstract

“…18 F-FDG PET/CT is a well-established, noninvasive diagnostic tool for the detection of a variety of malignant tumors such as neck, lung, pancreas, and colon tumors. [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.…”

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.…”

mentioning

confidence: 99%

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

et al. 2010

View full text Add to dashboard Cite

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,

show abstract

Impact of positron emission tomography on strategy in liver resection for primary and secondary liver tumors

Cited by 81 publications

References 46 publications

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

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

A Prospective Evaluation of¹⁸F-FDG and¹¹C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma

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

Contact Info

Product

Resources

About

Impact of positron emission tomography on strategy in liver resection for primary and secondary liver tumors

Cited by 81 publications

References 46 publications

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

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

A Prospective Evaluation of18F-FDG and11C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma

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

Contact Info

Product

Resources

About

A Prospective Evaluation of¹⁸F-FDG and¹¹C-Acetate PET/CT for Detection of Primary and Metastatic Hepatocellular Carcinoma

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