Research and application of <sup>18</sup>F-fluorodeoxyglucose positron emission tomography/ computed tomography for the diagnosis and treatment of primary hepatocellular carcinoma _Journal of Biomedical Engineering

Authors：

WANG Wei ,  YOU Jinhui

Department of Nuclear Medicine, the Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P.R.China;

Corresponding author：

YOU Jinhui, Email: youjh@126.com

Keywords：

primary hepatocellular carcinoma; fluor-18-deoxy-glucose; positron emission tomography/ computed tomography; diagnosis

DOI：

10.7507/1001-5515.201610046

Video：

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Primary hepatocellular carcinoma is a common cancer. Many patients are found with intermediate-advanced stage, rapid development, poor treatment and high mortality. ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) can discover the early lesions and therefore plays an important role in diagnosis, treatment and prognosis of patients with hepatocellular carcinoma. It especially has obvious advantages in detecting metastasis and monitoring recurrence. However, ¹⁸F-FDG PET/CT imaging has poor quality and low diagnosis rate. Understanding the advantages and limitations of ¹⁸F-FDG PET/CT can provide better basis for clinical diagnosis and treatment for hepatocellular carcinoma patients. This article briefly introduces the research and application of ¹⁸F-FDG PET/CT in the diagnosis and treatment of hepatocellular carcinoma.

Citation： WANG Wei, YOU Jinhui. Research and application of ¹⁸F-fluorodeoxyglucose positron emission tomography/ computed tomography for the diagnosis and treatment of primary hepatocellular carcinoma . Journal of Biomedical Engineering, 2017, 34(3): 480-484. doi: 10.7507/1001-5515.201610046 Copy

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2.	Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
3.	Trinchet J C, Bourcier V, Chaffaut C, et al. Complications and competing risks of death in compensated viral cirrhosis (ANRS CO12 CirVir prospective cohort). Hepatology, 2015, 62(3): 737-750.
4.	Mcglynn K A, Petrick J L, London W T. Global epidemiology of hepatocellular carcinoma: an emphasis on demographic and regional variability. Clin Liver Dis, 2015, 19(2): 223-238.
5.	Bruix J, Reig M, Sherman M. Evidence-Based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
6.	Kim M J, Kim Y S, Cho Y H, et al. Use of (18)F-FDG PET to predict tumor progression and survival in patients with intermediate hepatocellular carcinoma treated by transarterial chemoembolization. Korean J Intern Med, 2015, 30(3): 308-315.
7.	Hayano K, Fuentes-Orrego J M, Sahani D V. New approaches for precise response evaluation in hepatocellular carcinoma. World J Gastroenterol, 2014, 20(12): 3059-3068.
8.	Asman Y, Evenson A R, Even-Sapir E, et al. [¹⁸F]fludeoxyglucose positron emission tomography and computed tomography as a prognostic tool before liver transplantation, resection, and loco-ablative therapies for hepatocellular carcinoma. Liver Transpl, 2015, 21(5): 572-580.
9.	Tsurusaki M, Okada M, Kuroda H, et al. Clinical application of 18F-fluorodeoxyglucose positron emission tomography for assessment and evaluation after therapy for malignant hepatic tumor. J Gastroenterol, 2014, 49(1): 46-56.
10.	Simoneau E, Hassanain M, Madkhali A, et al. (18)F-Fluorodeoxyglucose positron-emission tomography could have a prognostic role in patients with advanced hepatocellular carcinoma. Curr Oncol, 2014, 21(4): e551-e556.
11.	Kuker R A, Mesoloras G, Gulec S A. Optimization of FDG-PET/CT imaging protocol for evaluation of patients with primary and metastatic liver disease. Int Semin Surg Oncol, 2007, 4: 17.
12.	Wolfort R M, Papillion P W, Turnage R H, et al. Role of FDG-PET in the evaluation and staging of hepatocellular carcinoma with comparison of tumor size, AFP level, and histologic grade. Int Surg, 2010, 95(1): 67-75.
13.	Lee J E, Jang J Y, Jeong S W, et al. Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan. World J Gastroenterol, 2012, 18(23): 2979-2987.
14.	Huo Li, Guo Jinxia, Dang Yonghong, et al. Kinetic analysis of dynamic (11)C-acetate PET/CT imaging as a potential method for differentiation of hepatocellular carcinoma and benign liver lesions. Theranostics, 2015, 5(4): 371-377.
15.	Cheung T T, Ho C L, Lo C M, et al. 11C-acetate and ¹⁸F-FDG PET/CT for clinical staging and selection of patients with hepatocellular carcinoma for liver transplantation on the basis of Milan criteria: surgeon's perspective. J Nucl Med, 2013, 54(2): 192-200.
16.	Chotipanich C, Kunawudhi A, Promteangtrong C, et al. Diagnosis of hepatocellular carcinoma using C11 choline PET/CT: comparison with F-18 FDG, ContrastEnhanced MRI and MDCT. Asian Pac J Cancer Prev, 2016, 17(7): 3569-3573.
17.	Attwa M H, El-Etreby S A. Guide for diagnosis and treatment of hepatocellular carcinoma. World J Hepatol, 2015, 7(12): 1632-1651.
18.	Ahn S Y, Lee J M, Joo I, et al. Prediction of microvascular invasion of hepatocellular carcinoma using gadoxetic acid-enhanced Mr and (18)F-FDG PET/CT. Abdom Imaging, 2015, 40(4): 843-851.
19.	Detry O, Govaerts L, Deroover A, et al. Prognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma. World J Gastroenterol, 2015, 21(10): 3049-3054.
20.	Lee J W, Hwang S H, Kim D Y, et al. Prognostic value of FDG uptake of portal vein tumor thrombosis in patients with locally advanced hepatocellular carcinoma. Clin Nucl Med, 2017, 42(1): e35-e40.
21.	Mano Y, Aishima S, Kubo Y, et al. Correlation between biological marker expression and fluorine-18 fluorodeoxyglucose uptake in hepatocellular carcinoma. Am J Clin Pathol, 2014, 142(3): 391-397.
22.	Song M J, Bae S H, Yoo I R, et al. Predictive value of ¹⁸F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma. World J Gastroenterol, 2012, 18(25): 3215-3222.
23.	Lee J W, Oh J K, Chung Y A, et al. Prognostic significance of ¹⁸F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy: a multicenter retrospective cohort study. J Nucl Med, 2016, 57(4): 509-516.
24.	Lee S D, Kim S H, Kim S K, et al. Clinical impact of ¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography in living donor liver transplantation for advanced hepatocellular carcinoma. Transplantation, 2015, 99(10): 2142-2149.
25.	Li Guang, Schmidtlein C R, Burger I A, et al. Assessing and accounting for the impact of respiratory motion on FDG uptake and viable volume for liver lesions in free-breathing PET using respiration-suspended PET images as reference. Med Phys, 2014, 41(9): 091905.

1. Díaz-González Á, Forner A, Rodríguez de Lope C, et al. New challenges in clinical research on hepatocellular carcinoma. Rev Esp Enferm Dig, 2016, 108(8): 485-493.
2. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
3. Trinchet J C, Bourcier V, Chaffaut C, et al. Complications and competing risks of death in compensated viral cirrhosis (ANRS CO12 CirVir prospective cohort). Hepatology, 2015, 62(3): 737-750.
4. Mcglynn K A, Petrick J L, London W T. Global epidemiology of hepatocellular carcinoma: an emphasis on demographic and regional variability. Clin Liver Dis, 2015, 19(2): 223-238.
5. Bruix J, Reig M, Sherman M. Evidence-Based diagnosis, staging, and treatment of patients with hepatocellular carcinoma. Gastroenterology, 2016, 150(4): 835-853.
6. Kim M J, Kim Y S, Cho Y H, et al. Use of (18)F-FDG PET to predict tumor progression and survival in patients with intermediate hepatocellular carcinoma treated by transarterial chemoembolization. Korean J Intern Med, 2015, 30(3): 308-315.
7. Hayano K, Fuentes-Orrego J M, Sahani D V. New approaches for precise response evaluation in hepatocellular carcinoma. World J Gastroenterol, 2014, 20(12): 3059-3068.
8. Asman Y, Evenson A R, Even-Sapir E, et al. [¹⁸F]fludeoxyglucose positron emission tomography and computed tomography as a prognostic tool before liver transplantation, resection, and loco-ablative therapies for hepatocellular carcinoma. Liver Transpl, 2015, 21(5): 572-580.
9. Tsurusaki M, Okada M, Kuroda H, et al. Clinical application of 18F-fluorodeoxyglucose positron emission tomography for assessment and evaluation after therapy for malignant hepatic tumor. J Gastroenterol, 2014, 49(1): 46-56.
10. Simoneau E, Hassanain M, Madkhali A, et al. (18)F-Fluorodeoxyglucose positron-emission tomography could have a prognostic role in patients with advanced hepatocellular carcinoma. Curr Oncol, 2014, 21(4): e551-e556.
11. Kuker R A, Mesoloras G, Gulec S A. Optimization of FDG-PET/CT imaging protocol for evaluation of patients with primary and metastatic liver disease. Int Semin Surg Oncol, 2007, 4: 17.
12. Wolfort R M, Papillion P W, Turnage R H, et al. Role of FDG-PET in the evaluation and staging of hepatocellular carcinoma with comparison of tumor size, AFP level, and histologic grade. Int Surg, 2010, 95(1): 67-75.
13. Lee J E, Jang J Y, Jeong S W, et al. Diagnostic value for extrahepatic metastases of hepatocellular carcinoma in positron emission tomography/computed tomography scan. World J Gastroenterol, 2012, 18(23): 2979-2987.
14. Huo Li, Guo Jinxia, Dang Yonghong, et al. Kinetic analysis of dynamic (11)C-acetate PET/CT imaging as a potential method for differentiation of hepatocellular carcinoma and benign liver lesions. Theranostics, 2015, 5(4): 371-377.
15. Cheung T T, Ho C L, Lo C M, et al. 11C-acetate and ¹⁸F-FDG PET/CT for clinical staging and selection of patients with hepatocellular carcinoma for liver transplantation on the basis of Milan criteria: surgeon's perspective. J Nucl Med, 2013, 54(2): 192-200.
16. Chotipanich C, Kunawudhi A, Promteangtrong C, et al. Diagnosis of hepatocellular carcinoma using C11 choline PET/CT: comparison with F-18 FDG, ContrastEnhanced MRI and MDCT. Asian Pac J Cancer Prev, 2016, 17(7): 3569-3573.
17. Attwa M H, El-Etreby S A. Guide for diagnosis and treatment of hepatocellular carcinoma. World J Hepatol, 2015, 7(12): 1632-1651.
18. Ahn S Y, Lee J M, Joo I, et al. Prediction of microvascular invasion of hepatocellular carcinoma using gadoxetic acid-enhanced Mr and (18)F-FDG PET/CT. Abdom Imaging, 2015, 40(4): 843-851.
19. Detry O, Govaerts L, Deroover A, et al. Prognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma. World J Gastroenterol, 2015, 21(10): 3049-3054.
20. Lee J W, Hwang S H, Kim D Y, et al. Prognostic value of FDG uptake of portal vein tumor thrombosis in patients with locally advanced hepatocellular carcinoma. Clin Nucl Med, 2017, 42(1): e35-e40.
21. Mano Y, Aishima S, Kubo Y, et al. Correlation between biological marker expression and fluorine-18 fluorodeoxyglucose uptake in hepatocellular carcinoma. Am J Clin Pathol, 2014, 142(3): 391-397.
22. Song M J, Bae S H, Yoo I R, et al. Predictive value of ¹⁸F-fluorodeoxyglucose PET/CT for transarterial chemolipiodolization of hepatocellular carcinoma. World J Gastroenterol, 2012, 18(25): 3215-3222.
23. Lee J W, Oh J K, Chung Y A, et al. Prognostic significance of ¹⁸F-FDG uptake in hepatocellular carcinoma treated with transarterial chemoembolization or concurrent chemoradiotherapy: a multicenter retrospective cohort study. J Nucl Med, 2016, 57(4): 509-516.
24. Lee S D, Kim S H, Kim S K, et al. Clinical impact of ¹⁸F-Fluorodeoxyglucose positron emission tomography/computed tomography in living donor liver transplantation for advanced hepatocellular carcinoma. Transplantation, 2015, 99(10): 2142-2149.
25. Li Guang, Schmidtlein C R, Burger I A, et al. Assessing and accounting for the impact of respiratory motion on FDG uptake and viable volume for liver lesions in free-breathing PET using respiration-suspended PET images as reference. Med Phys, 2014, 41(9): 091905.

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Research and application of ¹⁸F-fluorodeoxyglucose positron emission tomography/ computed tomography for the diagnosis and treatment of primary hepatocellular carcinoma