title: Prognostic value of pre-treatment F-18-FDG PET-CT in patients with hepatocellular carcinoma undergoing radioembolization.
abstract: OBJECTIVE
  To evaluate the value of pre-treatment 18F-FDG PET/CT in patients with HCC following liver radioembolization.
  
  
  METHODS
  We identified 34 patients with HCC who underwent an FDG PET/CT scan prior to hepatic radioembolization at our institution between 2009 and 2013. Patients were seen in clinic one month after radioembolization and then at 2-3 mo intervals. We assessed the influence of FDG tumor uptake on outcomes including local liver control (LLC), distant liver control (DLC), time to distant metastases (DM), progression free survival (PFS) and overall survival (OS).
  
  
  RESULTS
  The majority of patients were males (n= 25, 74%), and had Child Pugh Class A (n= 31, 91%), with a median age of 68 years (46-84 years). FDG-avid disease was found in 19 (56%) patients with SUVmax ranging from 3 to 20. Female patients were more likely to have an FDG-avid HCC (P= 0.02). Median follow up of patients following radioembolization was 12 months (1.2-62.8 mo). FDG-avid disease was associated with a decreased 1 year LLC, DLC, DM and PFS (P< 0.05). Using multivariate analysis, FDG avidity predicted for LLC, DLC, and PFS (allP< 0.05).
  
  
  CONCLUSIONS
  In this retrospective study, pre-treatment HCC FDG-avidity was found to be associated with worse LLC, DLC, and PFS following radioembolization. Larger studies are needed to validate our initial findings to assess the role of F-18-FDG PET/CT scans as biomarker for patients with HCC following radioembolization.
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Yazan
authors.initials: Y
authors.lastname: Abuodeh
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Arash O
authors.initials: AO
authors.lastname: Naghavi
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Kamran A
authors.initials: KA
authors.lastname: Ahmed
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Puja S
authors.initials: PS
authors.lastname: Venkat
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Youngchul
authors.initials: Y
authors.lastname: Kim
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Bela
authors.initials: B
authors.lastname: Kis
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Junsung
authors.initials: J
authors.lastname: Choi
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Biebel
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sweeney
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Anaya
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Richard
authors.initials: R
authors.lastname: Kim
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Mokenge
authors.initials: M
authors.lastname: Malafa
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Frakes
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hoffe
authors.affiliation: Yazan Abuodeh, Arash O Naghavi, Kamran A Ahmed, Puja S Venkat, Youngchul Kim, Jessica M Frakes, Sarah E Hoffe, Department of Radiation Oncology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, United States.
authors.forename: Ghassan
authors.initials: G
authors.lastname: El-Haddad
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000401:mortality / Q000532:radiotherapy* / Q000556:secondary; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D004621:Embolization, Therapeutic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005431:Florida; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D000072078:Positron Emission Tomography Computed Tomography; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015021:Yttrium Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019275:Radiopharmaceuticals; D015021:Yttrium Radioisotopes; D019788:Fluorodeoxyglucose F18
keywords: Biomarker; F-18 fluorodeoxyglucose PET; Hepatocellular carcinoma; Prognosis; Radioembolization