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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
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TitleThe use of dual-tracer PET/CT in selection of HCC patients based on Milan criteria before liver transplant
 
AuthorsHo, CL
Chen, SR
Cheung, TT
Cheng, TKC
Leung, YL
Wong, KN
 
Issue Date2012
 
PublisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
 
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. 47 [How to Cite?]
 
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
 
DescriptionGeneral Clinical Specialties: Gastroenterology
Fulltext in: http://jnumedmtg.snmjournals.org/cgi/content/meeting_abstract/53/1_MeetingAbstracts/47?sid=0505f31f-ae28-41d0-94c8-ffe5432b5689
 
ISSN0161-5505
2012 Impact Factor: 5.774
2012 SCImago Journal Rankings: 2.301
 
DC FieldValue
dc.contributor.authorHo, CL
 
dc.contributor.authorChen, SR
 
dc.contributor.authorCheung, TT
 
dc.contributor.authorCheng, TKC
 
dc.contributor.authorLeung, YL
 
dc.contributor.authorWong, KN
 
dc.date.accessioned2012-09-20T08:21:40Z
 
dc.date.available2012-09-20T08:21:40Z
 
dc.date.issued2012
 
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.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.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. 47 [How to Cite?]
 
dc.identifier.epageabstract no. 47
 
dc.identifier.hkuros211257
 
dc.identifier.issn0161-5505
2012 Impact Factor: 5.774
2012 SCImago Journal Rankings: 2.301
 
dc.identifier.issueSuppl. 1
 
dc.identifier.spageabstract no. 47
 
dc.identifier.urihttp://hdl.handle.net/10722/165647
 
dc.identifier.volume53
 
dc.languageeng
 
dc.publisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofThe Journal of Nuclear Medicine
 
dc.titleThe use of dual-tracer PET/CT in selection of HCC patients based on Milan criteria before liver transplant
 
dc.typeConference_Paper
 
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<item><contributor.author>Ho, CL</contributor.author>
<contributor.author>Chen, SR</contributor.author>
<contributor.author>Cheung, TT</contributor.author>
<contributor.author>Cheng, TKC</contributor.author>
<contributor.author>Leung, YL</contributor.author>
<contributor.author>Wong, KN</contributor.author>
<date.accessioned>2012-09-20T08:21:40Z</date.accessioned>
<date.available>2012-09-20T08:21:40Z</date.available>
<date.issued>2012</date.issued>
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<description.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&lt;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&#177;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&lt;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&lt;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</description.abstract>
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