Author information
1 Department of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, 6009, WA, Australia. michael.wallace2@health.wa.gov.au.
2 Medical School, University of Western Australia, Nedlands, WA, Australia. michael.wallace2@health.wa.gov.au.
3 School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia. michael.wallace2@health.wa.gov.au.
4 Department of Nuclear Medicine, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
5 Medical School, University of Western Australia, Nedlands, WA, Australia.
6 Department of Radiology, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
7 Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
8 School of Population and Global Health, University of Western Australia, Nedlands, WA, Australia.
9 Department of Hepatology, Sir Charles Gairdner Hospital, Hospital Avenue, Nedlands, Perth, 6009, WA, Australia.
Abstract
BACKGROUND AND AIMS:
18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) is an emerging functional imaging technique in the diagnosis and management of hepatocellular carcinoma (HCC). The aim of this study was to assess the ability of a pre- and post-treatment 18F-FCH PET/CT to predict prognosis and treatment response in early-stage HCC.
METHODS:
Patients with early- or intermediate-stage HCC planned for locoregional therapy were prospectively enrolled. Baseline demographic and tumor information was collected and baseline and post-treatment 18F-FCH PET/CT performed. Maximum standardized uptake values (SUVmax) were determined for each HCC lesion, and the difference between baseline and post-treatment SUVmax values were compared with progression-free survival outcomes.
RESULTS:
A total of 29 patients with 39 confirmed HCC lesions were enrolled from a single clinical center. Patients were mostly men (89.7%) with hepatitis C or alcohol-related cirrhosis (65.5%) and early-stage disease (89.7%). Per-patient and per-lesion sensitivity of 18F-FCH PET/CT was 72.4% and 59.0%, respectively. A baseline SUVmax < 13 was associated with a superior median progression-free survival compared with an SUVmax of > 13 (17.7 vs. 5.1 months; p = 0.006). A > 45% decrease in SUVmax between baseline and post-treatment 18F-FCH PET/CT ("responders") was associated with a superior mean progression-free survival than a percentage decrease of < 45% ("non-responders," 36.1 vs. 11.6 months; p = 0.034).
CONCLUSIONS:
Baseline and post-treatment 18F-FCH PET/CT predicts outcomes in early-stage HCC undergoing locoregional therapy. This technique may identify patients with an objective response post-locoregional therapy who would benefit from further therapy.