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Conference Paper: The use of dual-tracer PET/CT in selection of HCC patients based on Milan criteria before liver transplant

TitleThe use of dual-tracer PET/CT in selection of HCC patients based on Milan criteria before liver transplant
Authors
Issue Date2012
PublisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
Citation
The Society of Nuclear Medicine (SNM) 2012 Annual Meeting, Miami Beach, Florida, USA, 9-13 June 2012. In The Journal of Nuclear Medicine, 2012, v. 53 n. Suppl. 1, p. abstract no. 47 How to Cite?
Abstract
Objectives: Selection of HCC patients for liver transplant (LT) is crucial for prognosis and survival. The conventional tool for assessment is contrast CT but its accuracy is suboptimal for detection of early HCC in cirrhotic livers and for metastatic survey. We evaluated the accuracy of dual-tracer (11C-acetate: ACT and 18F-FDG: FDG) PET/CT in selecting candidates for LT based on Milan criteria. Methods: HCC patients status post LT or partial hepatectomy (HCC lesion<7 cm) with both preoperative dual-tracer PET/CT and contrast CT within 1 month were recruited into this study. Dual-tracer PET/CT and contrast CT were reviewed independently based on the parameters specified by Milan criteria: HCC lesion size and number, presence/absence of vascular invasion and extrahepatic metastasis, with postoperative pathology as the gold standard. Statistical analysis was performed using Chi-square test. Results: Forty three HCC patients (M: 34, F: 9, mean: 57±10.1 years) were included. Postoperative pathology confirmed 31 patients satisfying and 12 not satisfying Milan criteria. ACT (29/31: 93.5%) and dual-tracer (30/31: 96.8%) PET/CT were significantly more accurate in patient selection for LT than FDG (8/31: 25.8%) or contrast CT (13/31: 41.9%; all p<0.05). ACT (11/12: 91.7%) and dual-tracer (11/12: 91.7%) PET/CT were also more concordant with pathology in patient exclusion for LT than FDG (6/12: 50.0%) or contrast CT (4/12: 33.3%; all p<0.05). The discordance between contrast CT and pathology was due to: false negative diagnosis (n=17), HCC lesion size (n=6) and number (n=1), and overstaging by false positive diagnosis of vascular (n=2) and extrahepatic metastases (n=2). The discordance between dual-tracer PET/CT and pathology was found in 2 false negative cases with post-treatment necrosis. Conclusions: Dual-tracer PET/CT is significantly more accurate in preoperative assessment and selection of HCC patients for LT. Implementation of this imaging for transplant work-up may be considered
DescriptionGeneral Clinical Specialties: Gastroenterology
Persistent Identifierhttp://hdl.handle.net/10722/165647
ISSN
2013 Impact Factor: 5.563
2013 SCImago Journal Rankings: 2.254

 

DC FieldValueLanguage
dc.contributor.authorHo, CLen_US
dc.contributor.authorChen, SRen_US
dc.contributor.authorCheung, TTen_US
dc.contributor.authorCheng, TKCen_US
dc.contributor.authorLeung, YLen_US
dc.contributor.authorWong, KNen_US
dc.date.accessioned2012-09-20T08:21:40Z-
dc.date.available2012-09-20T08:21:40Z-
dc.date.issued2012en_US
dc.identifier.citationThe Society of Nuclear Medicine (SNM) 2012 Annual Meeting, Miami Beach, Florida, USA, 9-13 June 2012. In The Journal of Nuclear Medicine, 2012, v. 53 n. Suppl. 1, p. abstract no. 47en_US
dc.identifier.issn0161-5505-
dc.identifier.urihttp://hdl.handle.net/10722/165647-
dc.descriptionGeneral Clinical Specialties: Gastroenterology-
dc.descriptionFulltext in: http://jnumedmtg.snmjournals.org/cgi/content/meeting_abstract/53/1_MeetingAbstracts/47?sid=0505f31f-ae28-41d0-94c8-ffe5432b5689-
dc.description.abstractObjectives: Selection of HCC patients for liver transplant (LT) is crucial for prognosis and survival. The conventional tool for assessment is contrast CT but its accuracy is suboptimal for detection of early HCC in cirrhotic livers and for metastatic survey. We evaluated the accuracy of dual-tracer (11C-acetate: ACT and 18F-FDG: FDG) PET/CT in selecting candidates for LT based on Milan criteria. Methods: HCC patients status post LT or partial hepatectomy (HCC lesion<7 cm) with both preoperative dual-tracer PET/CT and contrast CT within 1 month were recruited into this study. Dual-tracer PET/CT and contrast CT were reviewed independently based on the parameters specified by Milan criteria: HCC lesion size and number, presence/absence of vascular invasion and extrahepatic metastasis, with postoperative pathology as the gold standard. Statistical analysis was performed using Chi-square test. Results: Forty three HCC patients (M: 34, F: 9, mean: 57±10.1 years) were included. Postoperative pathology confirmed 31 patients satisfying and 12 not satisfying Milan criteria. ACT (29/31: 93.5%) and dual-tracer (30/31: 96.8%) PET/CT were significantly more accurate in patient selection for LT than FDG (8/31: 25.8%) or contrast CT (13/31: 41.9%; all p<0.05). ACT (11/12: 91.7%) and dual-tracer (11/12: 91.7%) PET/CT were also more concordant with pathology in patient exclusion for LT than FDG (6/12: 50.0%) or contrast CT (4/12: 33.3%; all p<0.05). The discordance between contrast CT and pathology was due to: false negative diagnosis (n=17), HCC lesion size (n=6) and number (n=1), and overstaging by false positive diagnosis of vascular (n=2) and extrahepatic metastases (n=2). The discordance between dual-tracer PET/CT and pathology was found in 2 false negative cases with post-treatment necrosis. Conclusions: Dual-tracer PET/CT is significantly more accurate in preoperative assessment and selection of HCC patients for LT. Implementation of this imaging for transplant work-up may be considered-
dc.languageengen_US
dc.publisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org-
dc.relation.ispartofThe Journal of Nuclear Medicineen_US
dc.titleThe use of dual-tracer PET/CT in selection of HCC patients based on Milan criteria before liver transplanten_US
dc.typeConference_Paperen_US
dc.identifier.emailCheung, TT: cheung68@hku.hken_US
dc.identifier.hkuros211257en_US
dc.identifier.volume53en_US
dc.identifier.issueSuppl. 1en_US
dc.identifier.spageabstract no. 47en_US
dc.identifier.epageabstract no. 47en_US
dc.publisher.placeUnited States-

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