Diagnostic accuracy of 18F‐methylcholine positron emission tomography/computed tomography for intra‐ and extrahepatic hepatocellular carcinoma. Issue 3 (30th January 2014)

• Record Type: Journal Article
• Authors: Bieze, Matthanja; Klümpen, Heinz‐Josef; Verheij, Joanne; Beuers, Ulrich; Phoa, Saffire S.K.S.; van Gulik, Thomas M.; Bennink, Roelof J.
• Is Part Of: Hepatology. Volume 59:Issue 3(2014:Mar.)
• Page Start: 996
• Page End: 1006
• Publication Date: 2014-01-30
• Subjects: Heart -- Diseases -- Nursing -- Periodicals; Lungs -- Diseases -- Nursing -- Periodicals; Intensive care nursing -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1002/hep.26781
• Languages: English
• ISSNs: 0270-9139

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Diagnosis of hepatocellular carcinoma (HCC) primarily involves imaging. The aim of this study was to assess the accuracy of <sup>18</sup>F‐fluorocholine (<sup>18</sup>F‐FCH) positron emission tomography (PET) for detection of HCC and evaluation of extent of disease. Patients with HCC >1 cm were included between 2009 and July 2011, and follow‐up closed in February 2013. Diagnosis was based on American Association for the Study of Liver Diseases criteria, and all patients underwent <sup>18</sup>F‐FCH PET/computed tomography (CT) at baseline before treatment, 6 underwent a second PET/CT posttreatment, and 1 a third during follow‐up. Whole‐body PET and low‐dose CT imaging were performed 15 minutes after <sup>18</sup>F‐FCH injection. Evaluation of imaging was done with standardized uptake value (SUV) ratios: SUV maximum of the lesion divided by the SUV mean of surrounding tissue. Statistical analyses included descriptive analyses, receiver operating characteristic curve, McNemar's test, and Kaplan‐Meier's test at 5% level of significance. Twenty‐nine patients revealed 53 intrahepatic lesions. In 48 of 53 lesions, <sup>18</sup>F‐FCH PET was positive (SUV<sub>ratio</sub>, 1.95 ± 0.66; sensitivity, 88%; specificity, 100%). PET/CT showed uptake in 18 extrahepatic lesions and no uptake in 3 lesions affirmed non‐HCC lesions; all lesions were confirmed with additional investigation (accuracy, 100%). In 17 of 29 patients, additional lesions were found on PET/CT imaging, with implications for treatment in 15 patients. Posttreatment PET/CT showed identical results, compared with standard treatment evaluation. <italic>Conclusion</italic>: This study shows additional value of <sup>18</sup>F‐FCH PET/CT for patients with HCC. <sup>18</sup>F‐FCH PET/CT has implications for staging, management, and treatment evaluation because of accurate assessment of extrahepatic disease. (H<sc>epatology</sc> 2014;59:996–1006)</p> </abstract>