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18 F‐FDG‐Uptake of Hepatocellular Carcinoma on PET Predicts Microvascular Tumor Invasion in Liver Transplant Patients
Author(s) -
Kornberg A.,
Freesmeyer M.,
Bärthel E.,
Jandt K.,
Katenkamp K.,
Steenbeck J.,
Sappler A.,
Habrecht O.,
Gottschild D.
Publication year - 2009
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/j.1600-6143.2008.02516.x
Subject(s) - medicine , hepatocellular carcinoma , positron emission tomography , hazard ratio , liver transplantation , milan criteria , standardized uptake value , fluorodeoxyglucose , population , nuclear medicine , transplantation , radiology , oncology , confidence interval , environmental health
Vascular invasion of hepatocellular carcinoma (HCC) is a major risk factor for poor outcome after liver transplantation (LT). The aim of this retrospective analysis was to assess the value of preoperative positron emission tomography (PET) using 18 F‐fluorodeoxyglucose ( 18 F‐FDG) in liver transplant candidates with HCC for predicting microvascular tumor invasion (MVI) and posttransplant tumor recurrence.Forty‐two patients underwent LT for HCC after PET evaluation. Sixteen patients had an increased 18 F‐FDG tumor uptake on preoperative PET scans (PET +), while 26 recipients revealed negative PET findings (PET−) pre‐LT. PET− recipients demonstrated a significantly better 3‐year recurrence‐free survival (93%) than PET + patients (35%, p < 0.001). HCC recurrence rate was 50% in the PET + group, and 3.8% in the PET—population (p < 0.001). PET + status was identified as independent predictor of MVI [hazard ratio: 13.4]. Patients with advanced PET negative tumors and patients with HCC meeting the Milan criteria had a comparable 3‐year‐recurrence‐free survival (80% vs. 94%, p = 0.6).Increased 18 F‐FDG uptake on PET is predictive for MVI and tumor recurrence after LT for HCC. Its application may identify eligible liver transplant candidates with tumors beyond the Milan criteria.