Digestive Diseases and Sciences | 2019
Baseline and Post-treatment 18F-Fluorocholine PET/CT Predicts Outcomes in Hepatocellular Carcinoma Following Locoregional Therapy
Abstract
Background and Aims 18 F-fluorocholine positron emission tomography/computed tomography ( 18 F-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 18 F-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 18 F-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 18 F-FCH PET/CT was 72.4% and 59.0%, respectively. A baseline SUVmax <\u200913 was associated with a superior median progression-free survival compared with an SUVmax of >\u200913 (17.7 vs. 5.1\xa0months; p \u2009=\u20090.006). A\u2009>\u200945% decrease in SUVmax between baseline and post-treatment 18 F-FCH PET/CT (“responders”) was associated with a superior mean progression-free survival than a percentage decrease of <\u200945% (“non-responders,” 36.1 vs. 11.6\xa0months; p \u2009=\u20090.034). Conclusions Baseline and post-treatment 18 F-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.