title: Anti-alpha-fetoprotein imaging is useful for staging hepatoblastoma.
abstract: BACKGROUND
  Liver transplantation (Tx) has become an alternative treatment of malignant childhood liver tumors, and the importance of careful pretransplantation evaluation has been emphasized. Anti-alpha-fetoprotein (AFP) imaging has been suggested for evaluation of adult patients with AFP-positive tumors.
  
  
  METHODS
  Antibody imaging utilizing Tc-99 m-labeled monoclonal anti-AFP Fab' fragments was used to demonstrate pathologic uptake in hepatoblastoma (HB).
  
  
  RESULTS
  Radical operation or liver Tx was not possible after four cycles of chemotherapy in a child with HB because of a single extrahepatic metastasis. Chemotherapy was continued, and reevaluation with anti-AFP imaging demonstrated a pathologic uptake only in the liver. Subsequently, a right liver lobe resection was performed. Along with a new rise in serum AFP, repeated anti-AFP imaging revealed active liver tumor but no metastases. A liver Tx was performed, and the child is well with a normal serum AFP level 18 months after the operation.
  
  
  CONCLUSIONS
  This is the first case of pediatric HB in which anti-AFP imaging has been successfully used for patient management.
authors.affiliation: Children's Hospital and Department of Radiology, University of Helsinki, Helsinki, Finland.
authors.forename: Kalevi J A
authors.initials: KJ
authors.lastname: Kairemo
authors.forename: Harry
authors.initials: H
authors.lastname: Lindahl
authors.forename: Jussi
authors.initials: J
authors.lastname: Merenmies
authors.forename: Anna
authors.initials: A
authors.lastname: Föhr
authors.forename: Paivi
authors.initials: P
authors.lastname: Nikkinen
authors.forename: Sirkka-Liisa
authors.initials: SL
authors.lastname: Karonen
authors.forename: Anne
authors.initials: A
authors.lastname: Makipernaa
authors.forename: Krister
authors.initials: K
authors.lastname: Höckerstedt
authors.forename: David M
authors.initials: DM
authors.lastname: Goldenberg
authors.forename: Markku
authors.initials: M
authors.lastname: Heikinheimo
mesh_terms: D002675:Child, Preschool; D005260:Female; D018197:Hepatoblastoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D016031:Liver Transplantation; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D016719:Radioimmunodetection; D015899:Tomography, Emission-Computed, Single-Photon; D000509:alpha-Fetoproteins / Q000032:analysis / Q000276:immunology*
chemical_list: D000509:alpha-Fetoproteins