Anti-alpha-fetoprotein imaging is useful for staging hepatoblastoma.
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.
Kairemo
Kalevi J A
KJ
Children's Hospital and Department of Radiology, University of Helsinki, Helsinki, Finland.
Lindahl
Harry
H
Merenmies
Jussi
J
Föhr
Anna
A
Nikkinen
Paivi
P
Karonen
Sirkka-Liisa
SL
Makipernaa
Anne
A
Höckerstedt
Krister
K
Goldenberg
David M
DM
Heikinheimo
Markku
M
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*
D000509:alpha-Fetoproteins