title: Prognostic Value of Metabolic Parameters of 18F-FDG PET/CT and Apparent Diffusion Coefficient of MRI in Hepatocellular Carcinoma.
abstract: BACKGROUND
  The aim of this study was to predict the survival of patients with hepatocellular carcinoma (HCC) by examining metabolic PET parameters, apparent diffusion coefficients (ADCs), and clinical parameters.
  
  
  METHODS
  We retrospectively reviewed 52 patients with pathologically confirmed HCC (age, 57.9 ± 10.7 years; 43 men) who underwent MRI and F-FDG PET/CT. The tumor-to-normal liver SUV ratio (TLR), the mean ADC of each tumor, and other clinical data were obtained. Survival analysis was performed.
  
  
  RESULTS
  Thirty-two patients died during the follow-up period. There was an inverse correlation between the mean SUV and the mean ADC of a tumor (r = -0.402, P = 0.020). Among HCC patients, disease-specific survival was significantly associated with each of the following factors: high TLR (TLR ≥ 2; hazard ratio [HR], 3.78; P = 0.001), high mean ADC (mean ADC ≥ 1.250 × 10 mm/s; HR, 0.45; P = 0.028), AFP ≥ 400 ng/mL (HR, 3.48; P = 0.001), PIVKA-II ≥ 100mAU/mL (HR, 6.39; P = 0.011), tumor size (HR, 1.13; P < 0.001), number of tumors (HR, 2.16; P = 0.031), tumor stage (HR, 3.08; P < 0.001), and surgery for initial treatment (HR, 0.06; P < 0.001). The results of multivariate analysis show that DSS was significantly associated with each of the following factors: TLR ≥ 2 (HR, 2.46; P = 0.044), PIVKA-II ≥ 100mAU/mL (HR, 5.11; P = 0.037), tumor stage (HR, 3.01; P < 0.001), and surgery for initial treatment (HR, 0.04; P < 0.001).
  
  
  CONCLUSIONS
  High TLRs and low mean ADCs were associated with poor outcomes. The TLR was an independent prognostic factor in patients with HCC, but the mean ADC was not. A negative correlation was found between the mean ADC and the mean SUV of a tumor.
authors.affiliation: From the Departments of *Nuclear Medicine, and †Radiology, Kyungpook National University, School of Medicine and Hospital, Daegu, Republic of Korea.
authors.forename: Chae Moon
authors.initials: CM
authors.lastname: Hong
authors.forename: Byeong-Cheol
authors.initials: BC
authors.lastname: Ahn
authors.forename: Yun-Jin
authors.initials: YJ
authors.lastname: Jang
authors.forename: Shin Young
authors.initials: SY
authors.lastname: Jeong
authors.forename: Sang-Woo
authors.initials: SW
authors.lastname: Lee
authors.forename: Jaetae
authors.initials: J
authors.lastname: Lee
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18