title: ¹⁸F-FDG PET/CT in hepatocellular carcinoma: detection of bone metastasis and prediction of prognosis.
abstract: OBJECTIVE
  The purpose of this study was to assess the diagnostic accuracy and prognostic value of 18F-fluorodeoxyglucose PET/computed tomography (CT) in bone metastases from hepatocellular carcinoma (HCC).
  
  
  METHODS
  Of 3912 consecutive HCC patients, 67 patients who had undergone both PET/CT and bone scintigraphy (BS) within a 3-month interval were evaluated.
  
  
  RESULTS
  Bone metastases were most frequently found in the pelvis (20%), followed by the lumbar spine (14%) and long bones (13%). PET/CT was significantly more sensitive than BS in region-based analyses, with 273 confirmed bone metastases (96.7 vs. 52.7%, respectively; P<0.001), and in patient-based analyses (99 vs. 85%; P=0.042). The median survival period was 5 (range, 0.4-18) months. On univariate analysis, poor prognostic factors included age (<60 years), multiple bone metastases, lymph node metastasis, high serum α-fetoprotein (≥400 IU/ml), Child-Pugh class B, and high maximum standardized uptake value (SUVmax) of bone metastasis (>5.0). Large metabolic volume (≥200 cm3) of bone metastasis was another poor prognostic factor. On Cox regression analysis, high α-fetoprotein was the only poor prognostic factor with statistical significance.
  
  
  CONCLUSIONS
  PET/CT was more sensitive than BS in bone metastasis from HCC by both patient-based and region-based analyses, and offered additional information on survival. PET/CT can be helpful in early diagnosis and opportune treatment of bone metastasis from HCC.
authors.affiliation: aDepartment of Nuclear Medicine, Korea University College of Medicine bDepartment of Internal Medicine, Division of Oncology cDepartment of Nuclear Medicine, Yonsei University College of Medicine dYonsei Liver Cancer Special Clinic, Severance Hospital eDepartment of Molecular Medicine and Biopharmaceutical Sciences, WCU Graduate School of Convergence Science and Technology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hyo Jung
authors.initials: HJ
authors.lastname: Seo
authors.forename: Gun Min
authors.initials: GM
authors.lastname: Kim
authors.forename: Joo Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Won Jun
authors.initials: WJ
authors.lastname: Kang
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000556:secondary*; D001842:Bone and Bones / Q000000981:diagnostic imaging; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18