Clinical role of FDG-PET for HCC: relationship of glucose metabolic indicator to Japan Integrated Staging (JIS) score.
OBJECTIVE
The purpose of this study was to validate the usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose (FDG-PET) in predicting degree of malignancy and prognosis, evaluated in terms of Japan Integrated Staging (JIS) score, in cirrhotic patients with hepatocellular carcinoma (HCC).


METHODS
FDG-PET was performed in 50 patients with HCC. The activity within regions of interest placed over tumors was measured, and standardized uptake values (SUVs) were calculated by dividing the tissue activity by injected dose of radioactivity per unit body weight. SUV ratio (SUVR) was expressed as tumor-to-nontumor ratio of SUV. Patients were allocated to 3 groups of similar size: group A, SUVR < or = 1.1; group B, 1.1 < SUVR < 1.6; and group C, 1.6 < or = SUVR.


RESULTS
SUVR significantly correlated with tumor node metastasis stage score (p < 0.001) or JIS score (p = 0.022). Survival rate in SUVR group C was significantly lower than that in group A (p < 0.001), and close to being significantly lower than that in group B. On multivariate analysis, JIS scores 2 and > or = 3, SUVR group C were significantly related to survival (All p < 0.05).


CONCLUSIONS
SUVR was well associated with a tumor staging which is the factor of JIS score and with survival, and indicated malignancy and prognosis of patients especially with high-grade HCC.
Kawamura
Etsushi
E
Department of Nuclear Medicine, Graduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. etsushi-k@med.osaka-cu.ac.jp
Habu
Daiki
D
Ohfuji
Satoko
S
Fukushima
Wakaba
W
Enomoto
Masaru
M
Torii
Kenji
K
Kawabe
Joji
J
Kondo
Kyoko
K
Tamori
Akihiro
A
Kawada
Norifumi
N
Shiomi
Susumu
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000401:mortality; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007564:Japan; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose