1. Preoperative Fluorine 18 Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Prediction of Microvascular Invasion in Small Hepatocellular Carcinoma
- Author
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Yuki Nakamura, Fumi Honda, Keiichi Masaki, Norihito Nakano, Kazuaki Chayama, Yuko Nagaoki, Hideki Ohdan, Tomokazu Kawaoka, Michio Imamura, Takayuki Fukuhara, Masataka Tsuge, Kei Morio, Yoshiiku Kawakami, Reona Morio, Tomoki Kobayashi, Hiroshi Aikata, Kazuo Awai, Masahiro Hatooka, and Akira Hiramatsu
- Subjects
Adult ,Male ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Standardized uptake value ,Liver transplantation ,Sensitivity and Specificity ,03 medical and health sciences ,0302 clinical medicine ,Japan ,Fluorodeoxyglucose F18 ,Risk Factors ,Positron Emission Tomography Computed Tomography ,Preoperative Care ,Prevalence ,Carcinoma ,Humans ,Medicine ,Neoplasm Invasiveness ,Radiology, Nuclear Medicine and imaging ,Aged ,Aged, 80 and over ,Fluorine-18-fluorodeoxyglucose ,medicine.diagnostic_test ,Receiver operating characteristic ,business.industry ,Liver Neoplasms ,Reproducibility of Results ,Middle Aged ,Prognosis ,medicine.disease ,Positron emission tomography ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Microvessels ,Female ,030211 gastroenterology & hepatology ,Histopathology ,Radiology ,Radiopharmaceuticals ,business - Abstract
Objectives 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.
- Published
- 2016