期刊
CLINICAL NUCLEAR MEDICINE
卷 47, 期 6, 页码 E437-E443出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/RLU.0000000000004128
关键词
hepatocellular carcinoma; metabolic tumor volume; total lesion glycolysis; F-18-FDG PET; CT; dosimetry
资金
- National Research Foundation ofKorea - Ministry of Education, Science, and Technology [NRF-2020R1A2B5B01098109]
This study evaluated the prognostic value of metabolic parameters on F-18-FDG PET/CT and tumor dose (TD) on post-treatment Y-90 PET/CT in HCC patients undergoing Y-90 transarterial radioembolization (TARE). The results showed that TLG is a better prognostic factor for OS than TD in these patients.
Purpose This study aimed to evaluate the prognostic value of metabolic parameters on F-18-FDG PET/CT and tumor dose (TD) on posttreatment Y-90 PET/CT in patients with hepatocellular carcinoma (HCC) who underwent Y-90 transarterial radioembolization (TARE). Patients and Methods Forty-seven HCC patients treated with Y-90 TARE were retrospectively enrolled between January 2013 and October 2018. F-18-FDG PET/CT was performed before treatment. Maximum tumor SUV-to-mean normal liver SUV ratio (TLR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured for each patient. Voxel dosimetry was performed on Y-90 PET/CT images to measure TD. The prognostic significance of metabolic parameters on F-18-FDG PET/CT, TD on Y-90 PET/CT, and clinical factors for overall survival (OS) was evaluated. In addition, TD on Y-90 PET/CT was analyzed in relation to the administered dose of Y-90-labeled microspheres and metabolic parameters on F-18-FDG PET/CT. Results The median patient age was 57 years, and 37 patients (78.7%) were men. During the follow-up period, 25 patients (53.2%) died. In univariable analysis, Barcelona Clinic Liver Cancer stage C, Child-Pugh score, TD on Y-90 PET/CT, TLR, MTV, and TLG were significant prognostic factors affecting OS (P < 0.05). In multivariable analysis, Barcelona Clinic Liver Cancer stage C and high TLG on F-18-FDG PET/CT were independent prognostic factors for OS (P < 0.05). The 1-year OS rates were 72.9% in patients with low TLG and 33.3% in patients with high TLG (P < 0.05). We also found that TD on Y-90 PET/CT was not correlated with the administered dose of Y-90-labeled microspheres, but negatively correlated with TLG on pretreatment F-18-FDG PET/CT (P < 0.05). Conclusions TLG, a parameter incorporating both the degree of F-18-FDG uptake and amount of metabolically active tumor volume on pretreatment F-18-FDG PET/CT, is a better prognostic factor than TD on Y-90 PET/CT for predicting OS in HCC patients treated with Y-90 TARE.
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