title: Preoperative FDG-PET predicts recurrence patterns in hepatocellular carcinoma.
abstract: OBJECTIVE
  We investigated the usefulness of preoperative fluorine-18 fluorodeoxyglucose positron emission tomography (FDG-PET) as a tool for predicting recurrence patterns to select patients for liver resection as an initial surgical strategy for hepatocellular carcinoma.
  
  
  METHODS
  Sixty-three consecutive hepatocellular carcinoma patients undergoing FDG-PET were enrolled. They were classified according to the initial recurrence patterns (beyond the Milan criteria [MC], within the MC, and no recurrence) and the time intervals before initial postoperative recurrence (within 1 year, after 1 year or later, and no recurrence). The tumor-to-nontumor ratio (TNR) obtained by FDG-PET and survival rates were compared among the groups.
  
  
  RESULTS
  TNR in the recurrence within the MC group (1.9 ± 1.6) and no recurrence group (1.3 ± 1.5) was significantly lower than that in the beyond the MC group (2.9 ± 2.6). TNR was an independent predictive factor of recurrence patterns in multivariate analysis. TNR in the groups with recurrence after 1 year or later (1.6 ± 0.8) and no recurrence (1.3 ± 0.5) were significantly lower than that in the within 1-year group (3.1 ± 2.7). TNR was an independent predictive factor of the interval before initial recurrence by multivariate analysis.
  
  
  CONCLUSIONS
  Preoperative FDG-PET predicts hepatocellular carcinoma recurrences within the MC or no recurrence and recurrences after 1 year or later. FDG-PET may be useful for selecting appropriate patients for liver resection as an initial surgical strategy.
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. koji1976@kuhp.kyoto-u.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Kitamura
authors.forename: Etsuro
authors.initials: E
authors.lastname: Hatano
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Higashi
authors.forename: Satoru
authors.initials: S
authors.lastname: Seo
authors.forename: Yuji
authors.initials: Y
authors.lastname: Nakamoto
authors.forename: Kenya
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Taku
authors.initials: T
authors.lastname: Iida
authors.forename: Kojiro
authors.initials: K
authors.lastname: Taura
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yasuchika
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D049268:Positron-Emission Tomography; D011300:Preoperative Care; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18