Usefulness 18F-FDG positron emission tomography/computed tomography for detecting recurrence of hepatocellular carcinoma in posttransplant patients

Abstract

(18)F-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET)/computed tomography (CT) has recently been shown to be able to predict a poor outcome after liver transplantation (LT) for patients with hepatocellular carcinoma (HCC). However, there are few reports on the usefulness of PET during follow-up after LT. In this study, we assessed the efficacy of (18)F-FDG PET/CT for the detection of HCC recurrence after LT. From February 2005 to December 2008, out of 93 adult LT cases (91 living donors and 2 deceased donors), 10 patients who showed HCC recurrence and received (18)F-FDG PET/CT during follow-up were included. The accuracy of (18)F-FDG PET/CT was assessed with imaging and histological studies. The most common sites of recurrence were extrahepatic (60%). The most common extrahepatic sites were the lungs and bone (31.3% each). Among 4 patients with intrahepatic recurrence, 1 patient (25%) was positive according to (18)F-FDG PET/CT. The detection rate of (18)F-FDG PET/CT was 92.9% for extrahepatic metastases >or= 1 cm and 0% for lesions < 1 cm. The detection rate of (18)F-FDG PET/CT was 100% in bone and the lymph nodes, 60% in the lungs, and 0% in the brain. (18)F-FDG PET/CT identified 2 lesions in bone that were not found in a bone scan. In conclusion, because of its limitations for small lesions, intrahepatic lesions, and brain lesions, (18)F-FDG PET/CT is not suitable as a screening tool after LT. However, (18)F-FDG PET/CT could provide additional information beyond that provided by conventional modalities, and it could contribute to the clinical management of HCC recurrence after LT, especially in patients with extrahepatic recurrence.

(c) 2010 AASLD.