FDG PET/CT as a prognostic test after 90Y radioembolization in patients with metastatic hepatic disease.
The purpose of this study was to determine FDG PET/CT utility in predicting patient outcome undergoing Y RE for metastatic liver tumors.Thirty-one patients with metastatic tumors to the liver underwent Y RE between March 15, 2007, and May 5, 2011, at our institution. FDG PET/CT imaging was performed on each patient within 3 months before and after undergoing Y RE. Pretreatment and posttreatment FDG PET/CT were evaluated for SUV, number of liver lesions, and presence of disease outside the liver. The Kaplan-Meier method and Cox proportional hazard modeling was used to evaluate if SUV was a predictor of overall survival.Of the 31 patients, 12 were alive at the end of the study; median survival was 9 months (95% confidence interval, 7-18 months). The 24-month survival rate was 0.28 (95% confidence interval, 0.12-0.48). Kaplan-Meier analysis of preprocedure FDG PET/CT imaging showed no difference in rates of survival by number of lesions observed in the liver (P = 0.114) or presence of disease observed outside the liver (P = 0.719). Cases with new lesions outside the liver after treatment had significantly shorter survival times than cases without new lesions outside the liver (P = 0.002). Cox proportional hazard model showed that SUV levels before and after treatment were not significant predictors of overall survival.The appearance of new lesions outside the liver on FDG PET/CT within 3 months after Y RE was the only statistically significant variable in predicting poor outcome. Absence of new lesions outside the liver on postprocedure FDG PET/CT imaging helps identify patients achieving long-term survival.
Department of Hematology/Oncology, Olive View - UCLA Medical Center, Sylmar, Los Angeles, CA 90048, USA.
Martina
M
Zalom
Run
R
Yu
Marc
M
Friedman
Catherine
C
Bresee
Alan
A
Waxman
D004621:Embolization, Therapeutic; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000627:therapeutic use
D015021:Yttrium Radioisotopes; D019788:Fluorodeoxyglucose F18