The clinical value of 18F-FDG PET/CT for investigating unexplained serum AFP elevation following interventional therapy for hepatocellular carcinom.
OBJECTIVE
The goal of this study was to assess the clinical usefulness of 18F-FDG PET/ CT for investigating unexplained serum AFP elevation following interventional therapy such as transarterial chemoembolization (TAE) or radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC).


METHODS
A retrospective study was conducted involving 18 HCC patients (9 men and 9 women; age, 42-67 years) who underwent 18F-FDG PET/CT for evaluation of AFP without evidence of HCC recurrence on multiphasic abdominal CT after TAE or RFA treatment. The results of the 18F-FDG PET/CT were compared with histological, radiological and clinical follow-up.


RESULTS
Among 18 patients, 14 patients demonstrated HCC recurrence (10 intrahepatic, 3 extrahepatic and 1 intrahepatic/extrahepatic). Metastatic foci were found in the lung (1 patient), bone (1 patient), lymph node (1 patient), and adrenal gland (1 patient). The 18F-FDG PET/CT identified seven intrahepatic and four extrahepatic lesions. Overall, the 18F-FDG PET/CT had nine true-positives, five false-negatives, four true-negatives and zero false-positives for the detection of HCC recurrence. The sensitivity, specificity and accuracy were 64%, 100% and 72%, respectively.


CONCLUSIONS
When the multiphasic CT was normal, the 18F-FDG PET/CT was valuable to reveal intrahepatic tumor recurrence and/or extrahepatic metastases in patients with AFP elevation after interventional therapy for HCC.
Han
A-Reum
AR
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Gwak
Geum-Youn
GY
Choi
Moon Seok
MS
Lee
Joon Hyeok
JH
Koh
Kwang Cheol
KC
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000000981:diagnostic imaging* / Q000628:therapy; D017115:Catheter Ablation; D016461:Chemoembolization, Therapeutic; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014055:Tomography, Emission-Computed; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism*
D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals; D000509:alpha-Fetoproteins; D019788:Fluorodeoxyglucose F18