title: Predictability of preoperative 18F-FDG PET for histopathological differentiation and early recurrence of primary malignant intrahepatic tumors.
abstract: OBJECTIVE
  The limited studies with 18F-fluorodeoxyglucose (18F-FDG)-PET reported results and interpretations that differed between hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (IHCC). We investigated the correlation between preoperative PET results and postoperative prognosis, including early (time-to-recurrence<6 months) tumor recurrence, and histopathological tumor differentiation in patients who had undergone surgery for primary malignant intrahepatic tumors, including HCC and IHCC.
  
  
  METHODS
  We retrospectively reviewed 357 patients who had undergone curative surgery for malignant hepatic tumors, including primary HCC or IHCC, other than Klatskin tumors at a tertiary academic hospital between January 2005 and June 2012. All patients had undergone an 18F-FDG PET/computed tomography scan preoperatively and the maximum standardized uptake value of the tumor (max SUV tumor) and the tumor-to-nontumor SUV ratio (TNR) were calculated from 18F-FDG uptake. Histopathological differentiation grading was confirmed postoperatively.
  
  
  RESULTS
  Among the patients, 115 cases with primary malignant intrahepatic tumors fulfilled the inclusion criteria. On univariate analysis, preoperative max SUV tumor and TNR showed a correlation with the overall and early tumor recurrence of HCC, but only max SUV tumor was associated with overall and early recurrence of IHCC (P<0.05). When considering postoperative histopathological differentiation, a correlation between max SUV tumor and TNR with HCC and between max SUV tumor and IHCC was found (P<0.05). However, on multivariate analysis, only early recurrence was associated with TNR in HCC and with max SUV tumor in IHCC.
  
  
  CONCLUSIONS
  A preoperative 18F-FDG PET scan can be considered a useful reference for postoperative tumor recurrence and histopathological differentiation in cases of primary malignant intrahepatic tumors. 18F-FDG PET scan results should be interpreted separately for malignant liver tumors.
authors.affiliation: Departments of aInternal Medicine bNuclear Medicine cPathology dSurgery eRadiology, Digestive Disease Center and Research Institute, Soon Chun Hyang University Hospital Bucheon, Soon Chun Hyang University College of Medicine, Bucheon, Korea.
authors.forename: Jeong-Yeop
authors.initials: JY
authors.lastname: Song
authors.forename: Yun Nah
authors.initials: YN
authors.lastname: Lee
authors.forename: Young Seok
authors.initials: YS
authors.lastname: Kim
authors.forename: Sang Gyune
authors.initials: SG
authors.lastname: Kim
authors.forename: Soo Ji
authors.initials: SJ
authors.lastname: Jin
authors.forename: Jung Mi
authors.initials: JM
authors.lastname: Park
authors.forename: Gyu Seong
authors.initials: GS
authors.lastname: Choi
authors.forename: Jun Chul
authors.initials: JC
authors.lastname: Chung
authors.forename: Min Hee
authors.initials: MH
authors.lastname: Lee
authors.forename: Youn Hee
authors.initials: YH
authors.lastname: Cho
authors.forename: Moon Han
authors.initials: MH
authors.lastname: Choi
authors.forename: Dong Choon
authors.initials: DC
authors.lastname: Kim
authors.forename: Hyun Jong
authors.initials: HJ
authors.lastname: Choi
authors.forename: Jong Ho
authors.initials: JH
authors.lastname: Moon
authors.forename: Se Hwan
authors.initials: SH
authors.lastname: Lee
authors.forename: Seung Won
authors.initials: SW
authors.lastname: Jeong
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Jang
authors.forename: Hong Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Boo Sung
authors.initials: BS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography; D057234:Preoperative Period; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D019788:Fluorodeoxyglucose F18