title: 18F-FDG PET CT as a prognostic factor in hepatocellular carcinoma.
abstract: OBJECTIVE
  To elucidate the role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) imaging as an independent prognostic factor in hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 104 patients with newly diagnosed HCC who underwent 18F-FDG-PET/CT imaging from 2009 to 2014 were reviewed retrospectively. The ratio of the maximal tumor standardized uptake value (SUV) to the mean mediastinum SUV (TSUVmax/MSUVmean) was evaluated as the predictive factor.
  
  
  RESULTS
  A high TSUVmax/MSUVmean ratio (≥3.1) was significantly associated with tumor burden indices, including α-fetoprotein (p<0.001), amino transaminase (AST) (p=0.007), tumor size (p=0.043), Tumor, Node, and Metastasis (TNM) stage (p<0.001), and Barcelona Clinic Liver Cancer (BCLC) staging (p<0.001). The mortality rate was higher (48.1% vs. 23.1%, p<0.001) in patients with a high TSUVmax/MSUVmean ratio (≥3.1). Among the 47 patients who underwent transarterial chemoembolization (TACE), patients with a high TSUVmax/MSUVmean ratio (≥3.1) were more likely to have recurrence following TACE (18/19 vs. 18/28, p=0.016).
  
  
  CONCLUSIONS
  A high TSUVmax/MSUVmean ratio on 18F-FDG-PET/CT imaging can serve as an independent prognostic factor in HCC and may predict tumor recurrence after TACE.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. estevanj@naver.com.
authors.forename: Eunae
authors.initials: E
authors.lastname: Cho
authors.forename: Chung Hwan
authors.initials: CH
authors.lastname: Jun
authors.forename: Ban Seok
authors.initials: BS
authors.lastname: Kim
authors.forename: Dong Jun
authors.initials: DJ
authors.lastname: Son
authors.forename: Won Suk
authors.initials: WS
authors.lastname: Choi
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001219:Aspartate Aminotransferases / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000401:mortality; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D019275:Radiopharmaceuticals; D000509:alpha-Fetoproteins; D019788:Fluorodeoxyglucose F18; D001219:Aspartate Aminotransferases