(18)F-FDG PET/CT predicts survival after (90)Y transarterial radioembolization in unresectable hepatocellular carcinoma.
Details
Serval ID
serval:BIB_E1E635AA8F47
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
(18)F-FDG PET/CT predicts survival after (90)Y transarterial radioembolization in unresectable hepatocellular carcinoma.
Journal
European journal of nuclear medicine and molecular imaging
ISSN
1619-7089 (Electronic)
ISSN-L
1619-7070
Publication state
Published
Issued date
07/2017
Peer-reviewed
Oui
Volume
44
Number
7
Pages
1215-1222
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To compare the value of pretreatment functional and morphological imaging parameters for predicting survival in patients undergoing transarterial radioembolization using yttrium-90 ((90)Y-TARE) for unresectable hepatocellular carcinoma (uHCC).
We analysed data from 48 patients in our prospective database undergoing (90)Y-TARE treatment for uHCC (31 resin, 17 glass). All patients underwent (18)F-FDG PET/CT and morphological imaging (CT and MRI scans) as part of a pretherapeutic work-up. Patients did not receive any treatment between these imaging procedures and (90)Y-TARE. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were used to assess the prognostic value of (18)F-FDG PET/CT metabolic parameters, including SUVmax, tumour-to-liver (T/L) uptake ratio and SUVmean of healthy liver, and morphological data, including number and size of lesions, portal-venous infiltration (PVI). Relevant prognostic factors for HCC including Child-Pugh class, Barcelona Clinic Liver Cancer (BCLC) stage, tumour size, PVI and serum AFP level were compared with metabolic parameters in univariate and multivariate analyses.
The median follow-up in living patients was 16.2 months (range 11.4-50.1 months). Relapse occurred in 34 patients (70.8%) at a median of 7.4 months (range 1.4-27.9 months) after (90)Y-TARE, and relapse occurred in 24 of 34 patients (70.8%) who died from their disease at a median of 8.1 months (range 2.2-35.2 months). Significant prognostic markers for PFS were the mean and median lesion SUVmax (both P = 0.01; median PFS 10.2 vs. 7.4 months), and significant prognostic markers for OS were the first quarter (Q1) cut-off values for lesion SUVmax and T/L uptake ratio (both P = 0.02; median OS 30.9 vs. 9 months). The multivariate analysis confirmed that lesion SUVmax and T/L uptake ratio were independent negative predictors of PFS (hazard ratio, HR, 2.7, 95% CI 1.2-6.1, P = 0.02, for mean SUVmax; HR 2.6, 95% CI 1.1-5.9, P = 0.02, for median SUVmax:) and OS (HR 3.2, 95% CI 1-10.9, P = 0.04 for Q1 SUVmax; HR 3.7, 95% CI 1.1-12.2, P = 0.03, for Q1 T/L uptake ratio), respectively, when testing with either the BCLC staging system or serum AFP level.
Lesion SUVmax and T/L uptake ratio as assessed by (18)F-FDG PET/CT, but not morphological imaging, were predictive markers of survival in patients undergoing (90)Y-TARE for uHCC.
We analysed data from 48 patients in our prospective database undergoing (90)Y-TARE treatment for uHCC (31 resin, 17 glass). All patients underwent (18)F-FDG PET/CT and morphological imaging (CT and MRI scans) as part of a pretherapeutic work-up. Patients did not receive any treatment between these imaging procedures and (90)Y-TARE. Kaplan-Meier estimates of progression-free survival (PFS) and overall survival (OS) were used to assess the prognostic value of (18)F-FDG PET/CT metabolic parameters, including SUVmax, tumour-to-liver (T/L) uptake ratio and SUVmean of healthy liver, and morphological data, including number and size of lesions, portal-venous infiltration (PVI). Relevant prognostic factors for HCC including Child-Pugh class, Barcelona Clinic Liver Cancer (BCLC) stage, tumour size, PVI and serum AFP level were compared with metabolic parameters in univariate and multivariate analyses.
The median follow-up in living patients was 16.2 months (range 11.4-50.1 months). Relapse occurred in 34 patients (70.8%) at a median of 7.4 months (range 1.4-27.9 months) after (90)Y-TARE, and relapse occurred in 24 of 34 patients (70.8%) who died from their disease at a median of 8.1 months (range 2.2-35.2 months). Significant prognostic markers for PFS were the mean and median lesion SUVmax (both P = 0.01; median PFS 10.2 vs. 7.4 months), and significant prognostic markers for OS were the first quarter (Q1) cut-off values for lesion SUVmax and T/L uptake ratio (both P = 0.02; median OS 30.9 vs. 9 months). The multivariate analysis confirmed that lesion SUVmax and T/L uptake ratio were independent negative predictors of PFS (hazard ratio, HR, 2.7, 95% CI 1.2-6.1, P = 0.02, for mean SUVmax; HR 2.6, 95% CI 1.1-5.9, P = 0.02, for median SUVmax:) and OS (HR 3.2, 95% CI 1-10.9, P = 0.04 for Q1 SUVmax; HR 3.7, 95% CI 1.1-12.2, P = 0.03, for Q1 T/L uptake ratio), respectively, when testing with either the BCLC staging system or serum AFP level.
Lesion SUVmax and T/L uptake ratio as assessed by (18)F-FDG PET/CT, but not morphological imaging, were predictive markers of survival in patients undergoing (90)Y-TARE for uHCC.
Keywords
Aged, Arteries, Carcinoma, Hepatocellular/diagnostic imaging, Carcinoma, Hepatocellular/radiotherapy, Carcinoma, Hepatocellular/surgery, Disease-Free Survival, Embolization, Therapeutic, Female, Fluorodeoxyglucose F18, Humans, Liver Neoplasms/diagnostic imaging, Liver Neoplasms/radiotherapy, Liver Neoplasms/surgery, Male, Middle Aged, Positron Emission Tomography Computed Tomography, Survival Analysis, Yttrium Radioisotopes/therapeutic use, FDG PET/CT, Hepatocellular carcinoma, Imaging, Survival, TARE
Pubmed
Web of science
Create date
07/03/2017 20:30
Last modification date
12/06/2023 13:36
Usage data
