The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

Jeong Won Lee, Mijin Yun, Arthur Cho, KwangHyub Han, doyoung kim, Sang Mi Lee, Jong Doo Lee

Research output: Contribution to journalArticle

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Abstract

Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV 2SD , defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (T max /L mean ) was also calculated. The prognostic significance of MTV2SD and T max /L mean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, T max /L mean , and MTV 2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, T max /L mean , and MTV 2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV 2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

Original languageEnglish
Article numberA001
Pages (from-to)400-408
Number of pages9
JournalAnnals of Nuclear Medicine
Volume29
Issue number5
DOIs
Publication statusPublished - 2015 Jun 1

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Tumor Burden
Hepatocellular Carcinoma
Neoplasm Metastasis
Disease-Free Survival
Drug Therapy
Survival
Neoplasms
Liver
Fluorodeoxyglucose F18
alpha-Fetoproteins
Portal Vein
Reference Values
Thrombosis
Multivariate Analysis
Serum

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

@article{6c9415fe774f4b208b1df5c5ed02eb09,
title = "The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis",
abstract = "Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV 2SD , defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (T max /L mean ) was also calculated. The prognostic significance of MTV2SD and T max /L mean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, T max /L mean , and MTV 2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, T max /L mean , and MTV 2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV 2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.",
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The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis. / Lee, Jeong Won; Yun, Mijin; Cho, Arthur; Han, KwangHyub; kim, doyoung; Lee, Sang Mi; Lee, Jong Doo.

In: Annals of Nuclear Medicine, Vol. 29, No. 5, A001, 01.06.2015, p. 400-408.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

AU - Lee, Jeong Won

AU - Yun, Mijin

AU - Cho, Arthur

AU - Han, KwangHyub

AU - kim, doyoung

AU - Lee, Sang Mi

AU - Lee, Jong Doo

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV 2SD , defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (T max /L mean ) was also calculated. The prognostic significance of MTV2SD and T max /L mean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, T max /L mean , and MTV 2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, T max /L mean , and MTV 2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV 2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

AB - Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV 2SD , defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (T max /L mean ) was also calculated. The prognostic significance of MTV2SD and T max /L mean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, T max /L mean , and MTV 2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, T max /L mean , and MTV 2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV 2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

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