Early prediction of microvascular invasion (MVI) occurrence in hepatocellular carcinoma (HCC) by 18F-FDG PET/CT and laboratory data.

Background: Hepatocellular carcinoma (HCC) is one of the deadliest malignant tumors in China. Microvascular invasion (MVI) often indicates poor prognosis and metastasis in HCC patients. ¹⁸F-FDG PET–CT is a new imaging method commonly used to screen for tumor occurrence and evaluate tumor stage. Purpose: This study attempted to predict the occurrence of MVI in early-stage HCC through ¹⁸F-FDG positron emission tomography (PET)/computed tomography (CT) imaging findings and laboratory data. Patients and methods: A total of 113 patients who met the inclusion criteria were divided into two groups based on postoperative pathology: the MVI-positive group and MVI-negative group. We retrospectively analyzed the imaging findings and laboratory data of 113 patients. Imaging findings included tumor size, tumor _maximum standard uptake value (SUV_maxT), and normal liver _maximum standard uptake value (SUV_maxL). The ratios of SUV_maxT to SUV_maxL (SUV_maxT/L) and an SUV_maxT/L > 2 were defined as active tumor metabolism. The tumor size was indicated by the _maximum diameter of the tumor, and a diameter greater than 5 cm was defined as a mass lesion. The laboratory data included the alpha-fetoprotein (AFP) level and the HBeAg level. An AFP concentration > 20 ng/mL was defined as a high AFP level. A HBeAg concentration > 0.03 NCU/mL was defined as HB-positive. Results: The SUV_maxT/L (p = 0.003), AFP level (p = 0.008) and tumor size (p = 0.015) were significantly different between the two groups. Patients with active tumor metabolism, mass lesions and high AFP levels tended to be MVI positive. Binary logistic regression analysis verified that active tumor metabolism (OR = 4.124, 95% CI, 1.566–10.861; p = 0.004) and high AFP levels (OR = 2.702, 95% CI, 1.214–6.021; p = 0.015) were independent risk factors for MVI. The sensitivity of the combination of these two independent risk factors predicting HCC with MVI was 56.9% (29/51), the specificity was 83.9% (52/62) and the accuracy was 71.7% (81/113). Conclusion: Active tumor metabolism and high AFP levels can predict the occurrence of MVI in HCC patients. [ABSTRACT FROM AUTHOR]