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Article: Can positron emission tomography with the dual tracers [ 11C]acetate and [ 18F]fludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?
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TitleCan positron emission tomography with the dual tracers [ 11C]acetate and [ 18F]fludeoxyglucose predict microvascular invasion in hepatocellular carcinoma?
 
AuthorsCheung, TT1
Chan, SC1
Ho, CL2
Chok, KSH1
Chan, ACY1
Sharr, WW1
Ng, KKC1
Poon, RTP1
Lo, CM1
Fan, ST1
 
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
 
CitationLiver Transplantation, 2011, v. 17 n. 10, p. 1218-1225 [How to Cite?]
DOI: http://dx.doi.org/10.1002/lt.22362
 
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.
 
ISSN1527-6465
2013 Impact Factor: 3.793
 
DOIhttp://dx.doi.org/10.1002/lt.22362
 
ISI Accession Number IDWOS:000295234700013
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorCheung, TT
 
dc.contributor.authorChan, SC
 
dc.contributor.authorHo, CL
 
dc.contributor.authorChok, KSH
 
dc.contributor.authorChan, ACY
 
dc.contributor.authorSharr, WW
 
dc.contributor.authorNg, KKC
 
dc.contributor.authorPoon, RTP
 
dc.contributor.authorLo, CM
 
dc.contributor.authorFan, ST
 
dc.date.accessioned2011-07-27T01:36:26Z
 
dc.date.available2011-07-27T01:36:26Z
 
dc.date.issued2011
 
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.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationLiver Transplantation, 2011, v. 17 n. 10, p. 1218-1225 [How to Cite?]
DOI: http://dx.doi.org/10.1002/lt.22362
 
dc.identifier.doihttp://dx.doi.org/10.1002/lt.22362
 
dc.identifier.epage1225
 
dc.identifier.hkuros187485
 
dc.identifier.isiWOS:000295234700013
 
dc.identifier.issn1527-6465
2013 Impact Factor: 3.793
 
dc.identifier.issue10
 
dc.identifier.openurl
 
dc.identifier.pmid21688383
 
dc.identifier.scopuseid_2-s2.0-80053291972
 
dc.identifier.spage1218
 
dc.identifier.urihttp://hdl.handle.net/10722/135520
 
dc.identifier.volume17
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jtoc/106570021
 
dc.publisher.placeUnited States
 
dc.relation.ispartofLiver Transplantation
 
dc.relation.referencesReferences in Scopus
 
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?
 
dc.typeArticle
 
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<contributor.author>Chan, ACY</contributor.author>
<contributor.author>Sharr, WW</contributor.author>
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Author Affiliations
  1. The University of Hong Kong
  2. Hong Kong Sanatorium and Hospital