title: 18F-fluorodeoxyglucose PET/CT predicts tumour progression after transarterial chemoembolization in hepatocellular carcinoma.
abstract: OBJECTIVE
  (18)F-FDG PET monitoring of FDG uptake may be a useful tool for assessment of the biological behaviour of hepatocellular carcinoma (HCC). We evaluated the correlation between FDG uptake on (18)F-FDG PET and clinical characteristics and prognosis.
  
  
  METHODS
  In total, 58 HCC patients undergoing (18)F-FDG PET before transarterial chemoembolization (TACE) between May 2007 and May 2010 at Seoul St. Mary's Hospital were evaluated retrospectively. The predictive value of the ratio of maximal tumour standardized uptake value (SUV) to mean liver SUV (T(SUVmax)/L(SUVmean)) was tested. Primary endpoints were the clinical characteristics and treatment response according to T(SUVmax)/L(SUVmean). The secondary endpoint was time to progression (TTP).
  
  
  RESULTS
  A high SUV ratio (cutoff value 1.70) correlated significantly with tumour size (≥5 cm) and serum AFP level (≥400 ng/mL). Objective response rates were significantly different between those with a ratio above (15.7 %) and those with a ratio below (66.6 %) the cutoff value (P = 0.023). Patients in the low SUV ratio group had a median TTP of 16.8 months compared with 8.1 months in the high SUV ratio group (P = 0.011). Overall survival in the high SUV ratio group was worse than in the low SUV ratio group (median 56.5 vs. 23.3 months), although the difference was not statistically significant in a multivariate analysis.
  
  
  CONCLUSIONS
  Tumour metabolic activity (T(SUVmax)/L(SUVmean)), assessed by PET/CT, is an independent predictor of response to TACE in patients with intermediate-stage HCC. T(SUVmax)/L(SUVmean) can be used to predict tumour progression. Thus, (18)F-FDG PET can provide valuable information for prediction of prognosis and aid in decisions regarding treatment strategy.
authors: Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
authors: Myeong Jun
authors: MJ
authors: Song
authors: Si Hyun
authors: SH
authors: Bae
authors: Sung Won
authors: SW
authors: Lee
authors: Do Sun
authors: DS
authors: Song
authors: Hee Yeon
authors: HY
authors: Kim
authors: Ie Ryung
authors: IeR
authors: Yoo
authors: Joon-Il
authors: JI
authors: Choi
authors: Young June
authors: YJ
authors: Lee
authors: Ho Jong
authors: HJ
authors: Chun
authors: Hae Giu
authors: HG
authors: Lee
authors: Jong Young
authors: JY
authors: Choi
authors: Seung Kew
authors: SK
authors: Yoon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001158:Arteries / Q000473:pathology*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D018450:Disease Progression; D004621:Embolization, Therapeutic; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019788:Fluorodeoxyglucose F18