title: [Value of (18)F-FDG PET/CT and CECT in detecting postoperative recurrence and extrahepatic metastasis of hepatocellular carcinoma in patients with elevated serum alpha-fetoprotein].
abstract: OBJECTIVE
  To assess the clinical value of (18)F-FDG PET/CT and contrast-enhanced computed tomography (CECT) in detecting residual tumor or tumor recurrence and metastasis in patients with hepatocellular carcinoma (HCC) who show an elevated serum alpha-fetoprotein (AFP) level after surgical intervention.
  
  
  METHODS
  The data of (18)F-FDG PET/CT and CECT, which were performed at an interval within 2 weeks, were reviewed in 54 HCC patients showing elevated AFP levels after surgical interventions of the tumor. The patients were followed up for at least 6 months and the imaging findings were confirmed by pathological examination, follow-up imaging examination, or serum AFP level monitoring.
  
  
  RESULTS
  Forty-five patients were found to have focal intrahepatic HCC recurrence after surgical interventions, and 9 patients were free of HCC recurrence. Twenty-three patients developed extrahepatic metastasis, among whom 19 also had intrahepatic tumor recurrence and 4 had extrahepatic metastasis only. The sensitivity, specificity, and accuracy of (18)F-FDG PET/CT in the detection of HCC recurrence were 88.9% (40/45), 77.8% (7/9), and 87.0% (47/54), respectively, as compared with those of 57.8% (26/45), 100% (9/9), and 64.8% (35/54) by CECT detection.
  
  
  CONCLUSIONS
  Compared with CECT, (18)F-PET/CT shows a high sensitivity and accuracy in detecting postoperative tumor residual or recurrence in the liver, and can also be an effective modality for detecting extrahepatic lesions in HCC patients.
authors.affiliation: Department of Nuclear Medicine, First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China. chenfeng527@21cn.com
authors.forename: Zhifeng
authors.initials: Z
authors.lastname: Chen
authors.forename: Hong
authors.initials: H
authors.lastname: Liang
authors.forename: Xiangsong
authors.initials: X
authors.lastname: Zhang
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Wang
authors.forename: Weian
authors.initials: W
authors.lastname: Chen
authors.forename: Xinchong
authors.initials: X
authors.lastname: Shi
authors.forename: Chang
authors.initials: C
authors.lastname: Yi
authors.forename: Liangjun
authors.initials: L
authors.lastname: Rao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000000981:diagnostic imaging; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins; D019788:Fluorodeoxyglucose F18