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Imaging characteristics and prognostic values of hepatic epithelioid hemangioendothelioma on 18F-FDG PET/CT

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Abstract

Hepatic epithelioid hemangioendothelioma (HEHE) is a low-to-intermediate-grade malignant mesenchymal tumor. The diagnostic and prognostic values of 2-[18F] fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) to patients with HEHE have not been fully validated. Patient survival outcomes (including overall survival [OS] and progression-free survival [PFS]), lesions characteristics and semi-quantitative parameters, in terms of maximum standardized uptake value (SUVmax), peak SUV (SUVpeak), total lesion glycolysis (TLG) and metabolic tumor volume (MTV) on 18F-FDG PET/CT of 20 cases with HEHE were measured and analyzed. A total of 310 liver lesions were detected (excluding the diffuse-type lesions in 3 cases). Most lesions had higher SUVmax in delayed imaging than in early imaging (P = 0.013). Patients with multiple organs involved had higher death rate (P = 0.022), higher progression rate (P = 0.020), shorter OS (P = 0.011), larger lesion SUVmax (P = 0.048) and TLG (P = 0.033) than those with only liver involved. The area under curves (AUCs) from the receiver operating characteristic (ROC) curve analysis were 0.960, 0.949, 0.980 and 0.960 for SUVmax, SUVpeak, TLG and MTV, respectively, in predicting OS (P = 0.005, 0.008, 0.001 and 0.024, respectively). For predicting PFS, the AUCs were 0.791, 0.824, 0.857 and 0.813 (P = 0.036, 0.019, 0.010 and 0.024), respectively. Dual-time-point imaging may improve lesions detectability. Patients with multiple organ involved had worse prognosis. The higher SUVmax, SUVpeak, TLG and MTV of lesions, the worse prognosis of patients were found.

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Abbreviations

18F-FDG:

2-[18F] Fluoro-2-deoxy-D-glucose

PET/CT:

Positron emission tomography/computed tomography

HEHE:

Hepatic epithelioid hemangioendothelioma

OS:

Overall survival

PFS:

Progression-free survival

SUVmax :

Maximum standardized uptake value

SUVpeak :

Peak SUV

TLG:

Total lesion glycolysis

MTV:

Metabolic tumor volume

VOI:

Volume of interest

WB:

Whole body

RI:

Retention index

ROC:

Receiver operating characteristic

AUCs:

Areas under curves

SD:

Standard deviation

g:

Gram

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Acknowledgements

We thank Yuan Ji, M.D., Ph.D. for pathologic diagnosis in immunohistochemistry.

Funding

This study was partially supported by the National Natural Science Foundation of China (grant number: 81701730), the training program for excellent young medical talents of Zhongshan Hospital of Fudan University (grant number: 2019ZSYQ28) and the Shanghai "Rising Stars of Medical Talent" Youth Development Program (receiver: LG).

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Author notes

  1. Weimin Wang and Guobing Liu contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, People’s Republic of China

    Weimin Wang, Guobing Liu, Pengcheng Hu, Lifang Pang, Taoying Gu, Haojun Yu & Hongcheng Shi

  2. Department of Pathology, Zhongshan Hospital, Fudan University, No. 180 in Fenglin Road, Shanghai, 200032, People’s Republic of China

    Rongkui Luo

  3. Department of Liver Surgery, Liver Cancer Institute, Zhongshan Hospital, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, No. 1609 in Xietu Road, Shanghai, 200032, People’s Republic of China

    Xinrong Yang

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Contributions

WW, LG and SH contributed to study design, statistical analysis and overall manuscript generation; Material preparation and data collection were performed by HP, PL, GT, YH, YY and LR. All coauthors read and approved the entire manuscript.

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Correspondence to Hongcheng Shi.

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The authors declare that they have no competing interests.

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This study was approved by the institutional ethics committee. Informed consent was obtained from all patients included in the study.

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Wang, W., Liu, G., Hu, P. et al. Imaging characteristics and prognostic values of hepatic epithelioid hemangioendothelioma on 18F-FDG PET/CT. Clin Exp Med 20, 557–567 (2020). https://doi.org/10.1007/s10238-020-00653-0

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  • DOI: https://doi.org/10.1007/s10238-020-00653-0

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