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Article: Can positron emission tomography with the dual tracers [ 11C]acetate and [ 18F]fludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?

TitleCan positron emission tomography with the dual tracers [ 11C]acetate and [ 18F]fludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?
Authors
KeywordsAcetic acid c 11
Fluorodeoxyglucose f 18
Advanced cancer
Cancer invasion
Cancer recurrence
Issue Date2011
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
Citation
Liver Transplantation, 2011, v. 17 n. 10, p. 1218-1225 How to Cite?
Abstract
Microvascular invasion is a poor prognostic indicator of the recurrence of hepatocellular carcinoma (HCC) after surgical treatment. Positron emission tomography (PET) with [ 18F]fludeoxyglucose ([ 18F]FDG) as a tracer has been employed to predict the prognosis before surgery for various kinds of tumors, but it has not been found to be sensitive enough for HCC. Thus, [ 11C]acetate has been adopted as an additional tracer. This study was designed to evaluate the ability of dual-tracer PET ([ 18F]FDG and [ 11C]acetate) to predict microvascular invasion before liver resection or transplantation. Fifty-eight HCC patients who were preoperatively examined with whole-body dual-tracer PET were studied. Twenty-five patients were [ 18F]FDG-positive, and 56 were [ 11C]acetate-positive. The sensitivity of [ 18F]FDG in detecting primary HCC was 43%, and the sensitivity of [ 11C]acetate was 93%. Twenty-nine patients had HCC with microvascular invasion according to the final pathological examination. The sensitivity, specificity, positive predictive value, and negative predictive value of [ 18F]FDG PET in predicting microvascular invasion were 55.2%, 69%, 64%, and 60.6%, respectively; the corresponding rates for [ 11C]acetate PET were 93.1%, 0%, 48.2%, and 0%. The factors associated with HCC recurrence, which included multifocal involvement, a large tumor size, microsatellite lesions, poor HCC differentiation, and an advanced stage of disease, were analyzed and compared with positive PET results. A tumor size greater than 5 cm was significantly associated with positive [ 18F]FDG PET results; [ 11C]acetate was not associated with poor prognostic indicators. Preoperative [ 18F]FDG PET may predict microvascular invasion. The addition of [ 11C]acetate improves the overall sensitivity of PET, but it has no incremental value in predicting microvascular invasion. © 2011 AASLD.
Persistent Identifierhttp://hdl.handle.net/10722/135520
ISSN
2013 Impact Factor: 3.793
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
  2. Hong Kong Sanatorium and Hospital
DC FieldValueLanguage
dc.contributor.authorCheung, TTen_HK
dc.contributor.authorChan, SCen_HK
dc.contributor.authorHo, CLen_HK
dc.contributor.authorChok, KSHen_HK
dc.contributor.authorChan, ACYen_HK
dc.contributor.authorSharr, WWen_HK
dc.contributor.authorNg, KKCen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.date.accessioned2011-07-27T01:36:26Z-
dc.date.available2011-07-27T01:36:26Z-
dc.date.issued2011en_HK
dc.identifier.citationLiver Transplantation, 2011, v. 17 n. 10, p. 1218-1225en_HK
dc.identifier.issn1527-6465en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135520-
dc.description.abstractMicrovascular invasion is a poor prognostic indicator of the recurrence of hepatocellular carcinoma (HCC) after surgical treatment. Positron emission tomography (PET) with [ 18F]fludeoxyglucose ([ 18F]FDG) as a tracer has been employed to predict the prognosis before surgery for various kinds of tumors, but it has not been found to be sensitive enough for HCC. Thus, [ 11C]acetate has been adopted as an additional tracer. This study was designed to evaluate the ability of dual-tracer PET ([ 18F]FDG and [ 11C]acetate) to predict microvascular invasion before liver resection or transplantation. Fifty-eight HCC patients who were preoperatively examined with whole-body dual-tracer PET were studied. Twenty-five patients were [ 18F]FDG-positive, and 56 were [ 11C]acetate-positive. The sensitivity of [ 18F]FDG in detecting primary HCC was 43%, and the sensitivity of [ 11C]acetate was 93%. Twenty-nine patients had HCC with microvascular invasion according to the final pathological examination. The sensitivity, specificity, positive predictive value, and negative predictive value of [ 18F]FDG PET in predicting microvascular invasion were 55.2%, 69%, 64%, and 60.6%, respectively; the corresponding rates for [ 11C]acetate PET were 93.1%, 0%, 48.2%, and 0%. The factors associated with HCC recurrence, which included multifocal involvement, a large tumor size, microsatellite lesions, poor HCC differentiation, and an advanced stage of disease, were analyzed and compared with positive PET results. A tumor size greater than 5 cm was significantly associated with positive [ 18F]FDG PET results; [ 11C]acetate was not associated with poor prognostic indicators. Preoperative [ 18F]FDG PET may predict microvascular invasion. The addition of [ 11C]acetate improves the overall sensitivity of PET, but it has no incremental value in predicting microvascular invasion. © 2011 AASLD.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021en_HK
dc.relation.ispartofLiver Transplantationen_HK
dc.rightsLiver Transplantation. Copyright © John Wiley & Sons, Inc.-
dc.subjectAcetic acid c 11-
dc.subjectFluorodeoxyglucose f 18-
dc.subjectAdvanced cancer-
dc.subjectCancer invasion-
dc.subjectCancer recurrence-
dc.titleCan positron emission tomography with the dual tracers [ 11C]acetate and [ 18F]fludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1527-6465&volume=17&issue=10&spage=1218&epage=1225&date=2011&atitle=Can+positron+emission+tomography+with+the+dual+tracers+[11C]acetate+and+[18F]fludeoxyglucose+predict+microvascular+invasion+in+hepatocellular+carcinoma?-
dc.identifier.emailChan, SC: chanlsc@hkucc.hku.hken_HK
dc.identifier.emailChan, ACY: acchan@hku.hken_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityChan, SC=rp01568en_HK
dc.identifier.authorityChan, ACY=rp00310en_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1002/lt.22362en_HK
dc.identifier.pmid21688383en_HK
dc.identifier.scopuseid_2-s2.0-80053291972en_HK
dc.identifier.hkuros187485en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80053291972&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume17en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1218en_HK
dc.identifier.epage1225en_HK
dc.identifier.isiWOS:000295234700013-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridCheung, TT=7103334165en_HK
dc.identifier.scopusauthoridChan, SC=7404255575en_HK
dc.identifier.scopusauthoridHo, CL=7404653628en_HK
dc.identifier.scopusauthoridChok, KSH=6508229426en_HK
dc.identifier.scopusauthoridChan, ACY=15828849100en_HK
dc.identifier.scopusauthoridSharr, WW=36864499000en_HK
dc.identifier.scopusauthoridNg, KKC=7403179075en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK

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