2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma
Hepatocellular carcinoma (HCC) generally presents a low avidity for 2-deoxy-2-[<sup>18</sup>F]fluoro-<span style="font-variant: small-caps;">d</span>-glucose (FDG) in PET/CT although an increased FDG uptake seems to relate to more aggressive biological factors. To d...
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MDPI AG
2021-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/11/2554 |
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| author | Aida Sabaté-Llobera Judit Mestres-Martí Gabriel Reynés-Llompart Laura Lladó Kristel Mils Teresa Serrano Montserrat Cortés-Romera Esther Bertran Isabel Fabregat Emilio Ramos |
| author_facet | Aida Sabaté-Llobera Judit Mestres-Martí Gabriel Reynés-Llompart Laura Lladó Kristel Mils Teresa Serrano Montserrat Cortés-Romera Esther Bertran Isabel Fabregat Emilio Ramos |
| author_sort | Aida Sabaté-Llobera |
| collection | DOAJ |
| description | Hepatocellular carcinoma (HCC) generally presents a low avidity for 2-deoxy-2-[<sup>18</sup>F]fluoro-<span style="font-variant: small-caps;">d</span>-glucose (FDG) in PET/CT although an increased FDG uptake seems to relate to more aggressive biological factors. To define the prognostic value of PET/CT with FDG in patients with an HCC scheduled for a tumor resection, forty-one patients were prospectively studied. The histological factors of a poor prognosis were determined and FDG uptake in the HCC lesions was analyzed semi-quantitatively (lean body mass-corrected standardized uptake value (SUL) and tumor-to-liver ratio (TLR) at different time points). The PET metabolic parameters were related to the histological characteristics of the resected tumors and to the evolution of patients. Microvascular invasion (MVI) and a poor grade of differentiation were significantly related to a worse prognosis. The SULpeak of the lesion 60 min post-FDG injection was the best parameter to predict MVI while the SULpeak of the TLR at 60 min was better for a poor differentiation. Moreover, the latter parameter was also the best preoperative variable available to predict any of these two histological factors. Patients with an increased TLRpeak60 presented a significantly higher incidence of poor prognostic factors than the rest (75% vs. 28.6%, <i>p</i> = 0.005) and a significantly higher incidence of recurrence at 12 months (38% vs. 0%, <i>p</i> = 0.014). Therefore, a semi-quantitative analysis of certain metabolic parameters on PET/CT can help identify, preoperatively, patients with histological factors of a poor prognosis, allowing an adjustment of the therapeutic strategy for those patients with a higher risk of an early recurrence. |
| first_indexed | 2024-03-10T11:08:27Z |
| format | Article |
| id | doaj.art-86d0a560f39242cfb3bb8746691ac170 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T11:08:27Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-86d0a560f39242cfb3bb8746691ac1702023-11-21T20:58:37ZengMDPI AGCancers2072-66942021-05-011311255410.3390/cancers131125542-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular CarcinomaAida Sabaté-Llobera0Judit Mestres-Martí1Gabriel Reynés-Llompart2Laura Lladó3Kristel Mils4Teresa Serrano5Montserrat Cortés-Romera6Esther Bertran7Isabel Fabregat8Emilio Ramos9PET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, SpainPET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, SpainPET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, SpainPET Unit, Department of Nuclear Medicine-IDI, University Hospital of Bellvitge, L’Hospitalet de Llobregat, 08907 Barcelona, SpainOncology Program, Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBEREHD), National Biomedical Research Institute on Liver and Gastrointestinal Diseases, Instituto de Salud Carlos III, 28029 Madrid, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, SpainBellvitge Biomedical Research Institute (IDIBELL), L’Hospitalet de Llobregat, 08908 Barcelona, SpainHepatocellular carcinoma (HCC) generally presents a low avidity for 2-deoxy-2-[<sup>18</sup>F]fluoro-<span style="font-variant: small-caps;">d</span>-glucose (FDG) in PET/CT although an increased FDG uptake seems to relate to more aggressive biological factors. To define the prognostic value of PET/CT with FDG in patients with an HCC scheduled for a tumor resection, forty-one patients were prospectively studied. The histological factors of a poor prognosis were determined and FDG uptake in the HCC lesions was analyzed semi-quantitatively (lean body mass-corrected standardized uptake value (SUL) and tumor-to-liver ratio (TLR) at different time points). The PET metabolic parameters were related to the histological characteristics of the resected tumors and to the evolution of patients. Microvascular invasion (MVI) and a poor grade of differentiation were significantly related to a worse prognosis. The SULpeak of the lesion 60 min post-FDG injection was the best parameter to predict MVI while the SULpeak of the TLR at 60 min was better for a poor differentiation. Moreover, the latter parameter was also the best preoperative variable available to predict any of these two histological factors. Patients with an increased TLRpeak60 presented a significantly higher incidence of poor prognostic factors than the rest (75% vs. 28.6%, <i>p</i> = 0.005) and a significantly higher incidence of recurrence at 12 months (38% vs. 0%, <i>p</i> = 0.014). Therefore, a semi-quantitative analysis of certain metabolic parameters on PET/CT can help identify, preoperatively, patients with histological factors of a poor prognosis, allowing an adjustment of the therapeutic strategy for those patients with a higher risk of an early recurrence.https://www.mdpi.com/2072-6694/13/11/2554hepatocellular carcinoma2-[<sup>18</sup>F]FDGPET/CTliver resectionstandardized uptake valuelean body mass |
| spellingShingle | Aida Sabaté-Llobera Judit Mestres-Martí Gabriel Reynés-Llompart Laura Lladó Kristel Mils Teresa Serrano Montserrat Cortés-Romera Esther Bertran Isabel Fabregat Emilio Ramos 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma Cancers hepatocellular carcinoma 2-[<sup>18</sup>F]FDG PET/CT liver resection standardized uptake value lean body mass |
| title | 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma |
| title_full | 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma |
| title_fullStr | 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma |
| title_full_unstemmed | 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma |
| title_short | 2-[<sup>18</sup>F]FDG PET/CT as a Predictor of Microvascular Invasion and High Histological Grade in Patients with Hepatocellular Carcinoma |
| title_sort | 2 sup 18 sup f fdg pet ct as a predictor of microvascular invasion and high histological grade in patients with hepatocellular carcinoma |
| topic | hepatocellular carcinoma 2-[<sup>18</sup>F]FDG PET/CT liver resection standardized uptake value lean body mass |
| url | https://www.mdpi.com/2072-6694/13/11/2554 |
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