Combination of FDG-PET and UCSF criteria for predicting HCC recurrence after living donor liver transplantation

Chien Chin Hsu, Chao Long Chen, Chih Chi Wang, Chih Che Lin, Chee Chien Yong, Shih Ho Wang, Yueh Wei Liu, Ting Lung Lin, Wei Feng Lee, Yu Hung Lin, Yi Chia Chan, Yi Ju Wu, Hock Liew Eng, Yu Fan Cheng*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

41 Scopus citations

Abstract

Background. F-18 fluorodeoxyglucose (FDG) uptake in hepatocellular carcinoma (HCC) is related to tumor biology and has predictive value for tumor recurrence after liver transplantation. This retrospective study assessed whether the degree of FDG uptake in positron emission tomography (PET) can be used to predict HCC recurrence after living donor liver transplantation (LDLT). Methods.One hundred forty-seven patients with HCC underwent FDG-PETstudies before LDLT. The semiquantification of FDG uptake in FDG-positive HCC was done with maximum standardized uptake value (SUVmax) and tumor to nontumor ratio (TNR). Recurrence-free survivals (RFS) were calculated using the Kaplan-Meier method. Results. In univariable analysis, Tstage, presence ofmicrovascular invasion, being FDG-positive, SUVmax, and TNR were significant predictors for worse RFS. The optimal cutoff values of SUVmax and TNR were 4.8 and 2.0, respectively. The high FDG uptake HCC (TNR ≥ 2) was a strong predictor for worse RFS (hazard ratio, 13.52; 95% confidence interval, 4.77-38.29; P < 0.001). Using a combination of FDG-PETand University of California San Francisco (UCSF) criteria, the patients can be divided into low-risk (within UCSF criteria and FDG-negative), intermediate-risk (beyond UCSF criteria and FDG-negative; FDG-positive and TNR < 2), and high-risk (FDG-positive and TNR ≥ 2) groups. The estimated 5-year RFS in these groups were 85.5%, 83.9%, and 29.6% according to the combination of FDG-PET and clinical UCSF criteria, and 94.0%, 75.8%, and 29.6% according to the combination of FDG-PET and pathologic UCSF criteria, respectively. Conclusions. Combination of FDG-PET and UCSF criteria can be used to predict the risk of HCC recurrence after LDLT.

Original languageEnglish
Pages (from-to)1925-1932
Number of pages8
JournalTransplantation
Volume100
Issue number9
DOIs
StatePublished - 23 08 2016
Externally publishedYes

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© 2016 Wolters Kluwer Health, Inc. All rights reserved.

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