Prognostic Value of Metabolic Parameters of 18F-FDG PET/CT and Apparent Diffusion Coefficient of MRI in Hepatocellular Carcinoma

BACKGROUNDThe 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. METHODSWe retrospectively reviewed 52 patients with pathologically confirmed HCC (age, 5...

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Published in:Clinical nuclear medicine 2017-02, Vol.42 (2), p.95-99
Main Authors: Hong, Chae Moon, Ahn, Byeong-Cheol, Jang, Yun-Jin, Jeong, Shin Young, Lee, Sang-Woo, Lee, Jaetae
Format: Article
Language:English
Subjects:
Aged
Carcinoma, Hepatocellular - diagnostic imaging
Diffusion Magnetic Resonance Imaging
Female
Fluorodeoxyglucose F18
Humans
Liver Neoplasms - diagnostic imaging
Male
Middle Aged
Positron Emission Tomography Computed Tomography
Predictive Value of Tests
Radiopharmaceuticals
Retrospective Studies
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Summary:BACKGROUNDThe 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. METHODSWe 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. RESULTSThirty-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 factorshigh 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 factorsTLR ≥ 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). CONCLUSIONSHigh 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.
ISSN:0363-9762
1536-0229
DOI:10.1097/RLU.0000000000001478