title: Preoperative Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Prediction of Microvascular Invasion in Small Hepatocellular Carcinoma.
abstract: OBJECTIVE
  This study aimed to assess the value of preoperative fluorine 18 fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET-CT) for predicting microvascular invasion (MVI) in small hepatocellular carcinoma (HCC).
  
  
  METHODS
  We retrospectively examined 60 patients who received F-FDG PET-CT prior to hepatic resection for small HCC (≤30 mm) with subsequent MVI confirmation by histopathology. The associations between PET-positive status and tumor factors were assessed. Furthermore, independent predictors for MVI and diagnostic utility of each MVI predictor were assessed.
  
  
  RESULTS
  Multivariate analysis revealed the presence of MVI as an independent predictor of PET-positive status (P = 0.023). Maximum standardized uptake value (SUVmax) of 3.2 or greater (P = 0.017) and lens culinaris agglutinin a-reactive α-fetoprotein (AFP-L3) 19% or greater (P = 0.010) were independent predictors of MVI. Areas under the receiver operating characteristic curves for SUVmax of 3.2 or greater, AFP-L3 19% or greater, and both factors combined for predicting MVI were 0.712 (0.493-0.932), 0.755 (0.563-0.947), and 0.856 (0.721-0.991), respectively. The sensitivity and specificity for predicting MVI were 77.8% and 74.5% for SUVmax of 3.2 or greater, 66.7% and 84.3% for AFP-L3 19% or greater, and 88.9% and 82.4% for the combination.
  
  
  CONCLUSIONS
  F-FDG PET-CT and AFP-L3 may be useful for predicting MVI in small HCC, and the combination of the 2 factors provided reliable assessment for selection of suitable hepatic resection and liver transplantation candidates.
authors.affiliation: From the *Department of Gastroenterology and Metabolism, Hiroshima University Hospital; and †Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, ‡Department of Diagnostic Radiology, Graduate School of Biomedical Sciences, and §Liver Research Project Center, Hiroshima University, Hiroshima, Japan.
authors.forename: Tomoki
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Aikata
authors.forename: Fumi
authors.initials: F
authors.lastname: Honda
authors.forename: Norihito
authors.initials: N
authors.lastname: Nakano
authors.forename: Yuki
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hatooka
authors.forename: Kei
authors.initials: K
authors.lastname: Morio
authors.forename: Reona
authors.initials: R
authors.lastname: Morio
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukuhara
authors.forename: Keiichi
authors.initials: K
authors.lastname: Masaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nagaoki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Kawaoka
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Akira
authors.initials: A
authors.lastname: Hiramatsu
authors.forename: Michio
authors.initials: M
authors.lastname: Imamura
authors.forename: Yoshiiku
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
authors.forename: Kazuo
authors.initials: K
authors.lastname: Awai
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D008297:Male; D055806:Microvessels / Q000000981:diagnostic imaging / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods* / Q000706:statistics & numerical data; D011300:Preoperative Care / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18