Annals of Nuclear Medicine

, Volume 14, Issue 2, pp 121–126 | Cite as

Clinical usefulness of positron emission tomography with fluorine-18-fluorodeoxyglucose in the diagnosis of liver tumors

  • Yoshinori Iwata
  • Susumu Shiomi
  • Nobumitsu Sasaki
  • Hisato Jomura
  • Shuhei Nishiguchi
  • Shuichi Seki
  • Joji Kawabe
  • Hironobu Ochi
Original Articles
Received:
Accepted:

Abstract

We studied various liver tumors by positron emission tomography with fluorine-18 fluorodeoxyglucose (FDG-PET) to examine the diagnostic usefulness of this technique. We also examined the relation between findings on FDG-PET and the characteristics of hepatocellular carcinoma.

FDG-PET was performed in 78 patients with liver tumors, including 53 with primary liver cancer [48 hepatocellular carcinomas (HCC) and 5 cholangiocellular carcinomas (CCC)], 20 with metastatic liver cancer, 2 with liver hemangioma, and 3 with focal nodular hyperplasia. For quantitative evaluation, a region of interest (ROI) was placed over the entire tumor region, at the level of the maximum diameter of the tumor. A background ROI was then placed over the non-tumor region of the liver. The average activity within each ROI was subsequently corrected for radioactive decay, and the standardized uptake value (SUV) was calculated by dividing the tissue activity by the injected dose of radioactivity per unit body weight. SUV ratio was expressed as the tumor-to-non-tumor ratio of the SUV.

The median SUV was significantly lower in HCC than in metastatic live cancer or CCC, and the median SUV ratio was significantly lower in HCC than in metastatic liver cancer or CCC. The median SUV was not higher in multiple HCC than in single HCC, but the median SUV ratio was significantly higher in multiple HCC than in single HCC. The median SUV and the median SUV ratio were significantly higher in the presence of portal vein thrombosis than in the absence of such thrombosis. The Cancer of the Liver Italian Program score and the α-fetoprotein value correlated significantly with both the SUV and SUV ratio. These results suggest that FDG-PET is clinically useful not only for the differential diagnosis of liver tumors but also for evaluation of the clinical characteristics of HCC.

Key words

FDG-PET hepatocellular carcinoma cholangiocellular carcinoma metastatic liver cancer 
This is a preview of subscription content, log in to check access.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Warburg O, Wind F, Negelein E. On the metabolism of Tumors in the body.In: Warburg O, ed. The Metabolism of Tumors. London, Constable, pp. 254–265, 1930.Google Scholar
  2. 2.
    Sweeney MJ, Ashmore J, Morris HP, Weber G. Comparative biochemistry of hepatomas. IV. Isotope studies of glucose and fructose metabolism in liver tumors of different growth rates.Cancer Res 23: 995–1002, 1963.PubMedGoogle Scholar
  3. 3.
    Lo C, Cristrofalo VJ, Morris HP, Weinhouse S. Studies on respiration and glycolysis in transplanted hepatic tumors of the rat.Cancer Res 28: 1–10, 1968.PubMedGoogle Scholar
  4. 4.
    Burk D, Woods M, Hunter J. On the significance of glucolysis for cancer growth, with special reference to Morris rat hepatomas.J Natl Cancer Inst 38: 839–863, 1967.PubMedGoogle Scholar
  5. 5.
    DiChiro G, DeLaPaz RL, Brooks RA, Sokoloff L, Komblith PL, Smith BH, et al. Glucose utilization of cerebral gliomas measured by [18F]fluorodeoxyglucose and positron emission tomography.Neurology 32: 1323–1329, 1982.Google Scholar
  6. 6.
    Okazumi S, Isono K, Enomoto K, Kikuchi T, Ozaki M, Yamamoto H, et al. Evaluation of liver tumors using fluorine-18-fluorodeoxy-glucose PET: Characterization of tumor and assessment of effect of treatment.J Nucl Med 33: 333–339, 1992.PubMedGoogle Scholar
  7. 7.
    Messa C, Choi Y, Hoh CK, Jacobs EL, Glaspy JA, Rege S, et al. Quantification of glucose utilization in liver metastases: parametric imaging of FDG uptake with PET.J Comput Assist Tomogr 16: 684–689, 1992.PubMedCrossRefGoogle Scholar
  8. 8.
    The cancer of the liver Italian program (CLIP) investigator. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients.Hepatology 28: 751–755, 1998.CrossRefGoogle Scholar
  9. 9.
    Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices.Br J Surg 60: 646–649, 1973.PubMedCrossRefGoogle Scholar
  10. 10.
    Takayasu K, Kasugai H, Ikeya S, Muramatsu Y, Moriyama N, Makuuchi M, et al. A clinical and radiologic study of primary liver cancer associated with extrahepatic primary cancer.Cancer 69: 45–51, 1992.PubMedCrossRefGoogle Scholar
  11. 11.
    De Santis M, Romagnori R, Cristani A, Cioni G, Casolo A, Vici FF, et al. MRI of small hepatocellular carcinoma: comparison with US, CT, DSA, and Lipiodol-CT.J Comput Assist Tomogr 16: 189–197, 1992.PubMedCrossRefGoogle Scholar
  12. 12.
    Ogunbiyi OA, Flanagan FL, Dehdashti F, Siegel BA, Trask DD, Birnbaum EH, et al. Detection of recurrent and metastatic colorectal cancer: comparison of positron emission tomography and computed tomography.Ann Surg Oncol 4: 613–620, 1997.PubMedCrossRefGoogle Scholar
  13. 13.
    Crippa F, Gavazzi C, Bozzetti F, Chiesa C, Pascali C, Bogni A, et al. The influence of blood glucose levels on [18F] fluorodeoxyglucose (FDG) uptake in cancer: a PET study in liver metastases from colorectal carcinomas.Tumori 83: 748–752, 1997.PubMedGoogle Scholar
  14. 14.
    Yonekura Y, Benua RS, Brill AB, Som P, Yeh SDJ, Kemeny NE, et al. Increased accumulation of 2-deoxy-2-F-18-fluoro-d-glucose in liver metastases from colon carcinoma.J Nucl Med 23: 1133–1137, 1982.PubMedGoogle Scholar
  15. 15.
    Paulus P, Hustinx R, Daenen F, Jacquet N, Rigo P. Usefulness of 18-FDG positron emission tomography in detection and follow up of digestive cancers.Acta Gastroenterol Belg 60: 278–280, 1997.PubMedGoogle Scholar
  16. 16.
    Itai Y, Araki T, Furui S, Tasaka A. Differential diagnosis of hepatic masses on computed tomography, with particular reference to hepatocellular carcinoma.J Comput Assist Tomogr 5: 834–842, 1981.PubMedCrossRefGoogle Scholar
  17. 17.
    Keiding S, Hansen SB, Rasmussen HH, Gee A, Kruse A, Roelsgaard K, et al. Detection of cholangiocarcinoma in primary sclerosing cholangitis by positron emission tomography.Hepatology 28: 700–706, 1998.PubMedCrossRefGoogle Scholar
  18. 18.
    Shiomi S, Sasaki N, Kawashima D, Jomura H, Fukuda T, Kuroki T, et al. Combined hepatocellular carcinoma and cholangiocarcinoma with high F-18 fluorodeoxyglucose positron emission tomographic uptake.Clin Nucl Med 24: 370–371, 1999.PubMedCrossRefGoogle Scholar
  19. 19.
    Torizuka T, Tamaki N, Inokuma T, Magata Y, Sasayama S, Yonekura Y, et al.In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET.J Nucl Med 36: 1811–1817, 1995.PubMedGoogle Scholar
  20. 20.
    Megyesi C, Samols E, Marks V. Glucose tolerance and diabetes in chronic liver disease.Lancet 2: 1051–1056, 1967.PubMedCrossRefGoogle Scholar
  21. 21.
    Langen KJ, Braun U, Rota Kops E, Herzog H, Kuwert T, Nebeling B, et al. The influence of plasma glucose levels on fluorine-18-fluorodeoxyglucose uptake in bronchial carcinomas.J Nucl Med 34: 355–359, 1993.PubMedGoogle Scholar

Copyright information

© Springer 2000

Authors and Affiliations

  • Yoshinori Iwata
    • 2
  • Susumu Shiomi
    • 2
  • Nobumitsu Sasaki
    • 2
  • Hisato Jomura
    • 2
  • Shuhei Nishiguchi
    • 2
  • Shuichi Seki
    • 2
  • Joji Kawabe
    • 1
  • Hironobu Ochi
    • 1
  1. 1.Division of Nuclear MedicineOsaka City University Medical SchoolOsakaJapan
  2. 2.Third Department of Internal MedicineOsaka City University Medical SchoolOsakaJapan

Personalised recommendations