title: Prognostic value of 18F-FDG PET for hepatocellular carcinoma patients treated with sorafenib.
abstract: BACKGROUND
  Sorafenib (Nexavar) is an orally active multikinase inhibitor that is approved for the treatment of hepatocellular carcinoma (HCC). In this study, we used (18) F-2-fluoro-2-deoxyglucose ((18) F-FDG) with positron emission tomography (PET) to predict the treatment outcome of sorafenib in patients with advanced HCC.
  
  
  METHODS
  A total of 29 patients with HCC were included. Baseline (18) F-FDG PET scans were performed a median of 14 days before sorafenib treatment. Sorafenib was administered orally at a dose of 400 mg twice daily. For statistical analysis, the standardized uptake value (SUV) of the most hypermetabolic lesion was obtained and assigned as the SUVmax for each patient.
  
  
  RESULTS
  Among 29 patients, one patient achieved partial remission and 14 patients showed stable disease. The overall survival (OS) and progression free survival (PFS) were 5.1 months [95% confidence interval (CI): 0.0-12.0] and 3.8 months (95% CI: 1.4-6.2). The multivariate analysis of OS showed that four indices, Eastern Cooperative Oncology Group performance status, α-fetoprotein (AFP) concentration, portal vein thrombosis and SUVmax were significant prognostic factors (P=0.030, P=0.024, P=0.020 and P=0.015 respectively). AFP concentration and SUVmax were independent prognostic factors for PFS, too (P=0.003 and P=0.026 respectively). When the patients were divided into two groups: low SUVmax (n=10; <5.00) and high SUVmax (n=19;≥ 5.00), the low SUV group showed significantly longer OS and PFS (P=0.023 and P=0.042 respectively).
  
  
  CONCLUSIONS
  Our study showed that the degree of FDG uptake is an independent prognostic factor in patients with HCC who undergo sorafenib treatment.
authors: Department of Diagnostic Radiology, Yonsei University College of Medicine, Seoul, Korea.
authors: Jae Hoon
authors: JH
authors: Lee
authors: Jun Yong
authors: JY
authors: Park
authors: Do Young
authors: DY
authors: Kim
authors: Sang Hoon
authors: SH
authors: Ahn
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Hyo Jung
authors: HJ
authors: Seo
authors: Jong Doo
authors: JD
authors: Lee
authors: Hye Jin
authors: HJ
authors: Choi
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000201:enzymology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use*; D019275:Radiopharmaceuticals; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D000077157:Sorafenib; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D047428:Protein Kinase Inhibitors; D011725:Pyridines; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D009536:Niacinamide; D000077157:Sorafenib