title: Prognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
abstract: OBJECTIVE
  To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT).
  
  
  METHODS
  The authors retrospectively analyzed the data of 27 patients (mean age 58 ± 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma. Mean follow-up was 26 ± 18 mo. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min, low-dose non-enhanced CT. The authors measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function.
  
  
  RESULTS
  Overall and recurrence free survivals were 80.7% and 67.4% at 3 years, and 70.6% and 67.4% at 5 years, respectively. According to a multivariate Cox model, only FDG PET/CT RSUVmax predicted recurrence free survival. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax < 1.15 relapsed.
  
  
  CONCLUSIONS
  FDG PET/CT with an RSUVmax cut-off value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series. Further prospective studies should test whether this metabolic index should be systematically included in the preoperative assessment.
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Olivier
authors.initials: O
authors.lastname: Detry
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Govaerts
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Deroover
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Morgan
authors.initials: M
authors.lastname: Vandermeulen
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meurisse
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Serge
authors.initials: S
authors.lastname: Malenga
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Noella
authors.initials: N
authors.lastname: Bletard
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Charles
authors.initials: C
authors.lastname: Mbendi
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Lamproye
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Honoré
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Meunier
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Jean
authors.initials: J
authors.lastname: Delwaide
authors.affiliation: Olivier Detry, Arnaud Deroover, Morgan Vandermeulen, Nicolas Meurisse, Pierre Honoré, Department of Abdominal Surgery and Transplantation, CHU Liege, B4000 Liege, Belgium.
authors.forename: Roland
authors.initials: R
authors.lastname: Hustinx
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Cancer; Hepatocellular cancer; Hepatoma; Liver transplantation