Investigating the value of pre-treatment 18F-FDG PET/CT in predicting the pathological characteristic of hepatocellular carcinoma and recurrence after liver transplantation

Purpose The aim of this study is to investigate the value of pre-treatment F-18-FDG PET/CT in predicting the pathological characteristic of HCC and recurrence after liver transplantation (LT). Methods A total of 34 patients who underwent F-18-FDG PET/CT before LT for HCC and did not receive any other treatment were retrospectively enrolled in the study. The maximal standard uptake value of the tumor (T-SUVmax), normal liver tissues (L-SUVmax), and mediastinal blood pool (B-SUVmax) were derived, followed by the calculations of the T-SUVmax/L-SUVmax (T/L) and the T-SUVmax/B-SUVmax (T/B) ratios. Combined with the post-transplantation pathological results and ROC curve, the performance in predicting the pathological characteristic and the recurrence after LT were evaluated. Results The AUCs for T-SUVmax, T/L, and T/B in predicting the pathological grade of tumors were 0.820, 0.784, and 0.806, respectively. Alternatively, the AUCs for T-SUVmax, T/L, and T/B in predicting the recurrence after LT were 0.865, 0.899, and 0.931, respectively. The individual cutoff values were 5.0, 1.7, and 2.2, corresponding to a predication accuracy of 88.2%, 85.3%, and 88.2%, respectively. In addition, the AUCs for T/B in predicting microvascular invasion (mVI) and liver capsular invasion (LCI) were 0.825 and 0.788, respectively. Conclusion The pre-treatment F-18-FDG PET/CT is effective for predicting recurrence of HCC after LT. In addition, it demonstrates values for predicting the pathological characteristic of HCC such as pathological grade, mVI, and LCI.

Automated summary

The pre-treatment F-18-FDG PET/CT is effective in predicting the recurrence of HCC after liver transplantation and also shows value in predicting the pathological characteristics of HCC, such as pathological grade, microvascular invasion, and liver capsular invasion.