Metabolic activity assessment by 18 F-fluorodeoxyglucose positron emission tomography in patients with hepatocellular carcinoma undergoing Yttrium-90 transarterial radioembolization

J Gastroenterol Hepatol. 2021 Jun;36(6):1679-1684. doi: 10.1111/jgh.15357. Epub 2021 Jan 31.

Abstract

Background and aim: 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a functional image technique that can inform clinical decisions related to prognosis. We investigated the predictive role of 18 F-fluorodeoxyglucose PET/CT in patients with hepatocellular carcinoma (HCC) undergoing Yttrium-90 (Y-90) transarterial radioembolization (TARE).

Methods: Patients with HCC treated with TARE and pre-TARE PET/CT scan were recruited between 2009 and 2013. Maximum standardized uptake value and tumor-to-non-tumorous liver uptake ratio (TLR) were measured. Tumor response was evaluated in accordance with modified RECIST criteria at 3-month intervals after Y-90 TARE.

Results: Forty patients were included in the final analysis. The median age was 56.5 years and male predominant. Disease control in treated lesion was achieved in 82.5% (n = 33) of patients. During median 18.3-month follow-up, 27.5% (n = 11) of patients achieved progression-free survival. The cutoff of TLR, which was related to the median value, did not affect disease control rate, progression-free survival, and overall survival in patients with Y-90 TARE.

Conclusions: The TLR-based stratification may be a simple method, but our study did not show the usefulness in predicting prognosis in HCC patients with Y-90 TARE. Further studies with large number of patients are needed.

Keywords: Hepatocellular carcinoma; Positron emission tomography; Yttrium-90.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / methods*
  • Carcinoma, Hepatocellular / diagnostic imaging*
  • Carcinoma, Hepatocellular / metabolism
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / radiotherapy*
  • Embolization, Therapeutic / methods*
  • Female
  • Fluorodeoxyglucose F18*
  • Follow-Up Studies
  • Humans
  • Liver Neoplasms / diagnostic imaging*
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / mortality
  • Liver Neoplasms / radiotherapy*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography / methods*
  • Radiopharmaceuticals / therapeutic use*
  • Survival Rate
  • Treatment Outcome
  • Yttrium / therapeutic use*
  • Yttrium Radioisotopes / therapeutic use*

Substances

  • Radiopharmaceuticals
  • Yttrium Radioisotopes
  • Fluorodeoxyglucose F18
  • Yttrium