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An FDG PET/CT metabolic parameter-based nomogram for predicting the early recurrence of hepatocellular carcinoma after liver transplantation

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Abstract

Purpose

To construct an FDG PET/CT metabolic parameter-based model to predict early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).

Methods

A total of 62 patients with HCC after LT were enrolled with a follow-up period of 1 year. Basic clinical, pathology, and laboratory data, CT features (CPLC), and PET metabolic parameters (CPLCP) were collected for model construction. A CPLC nomogram without metabolic parameters and a CPLCP nomogram with metabolic parameters were established. The net reclassification index (NRI) and integrated discrimination improvement (IDI) of the two models were calculated. The constructed model was compared with Milan criteria and University of California San Francisco (UCSF) criteria. The time-dependent area under the receiver operating characteristic curve (time-AUC) was used to compare the efficiency of the models, and the bootstrap method was used to for verification. Harrell’s concordance index (C-index) was used to evaluate the performance of these models. Decision curve analysis (DCA) was used to evaluate the clinical practicability of each model.

Results

Thirty out of 62 patients experienced a recurrence during the 1-year follow-up. BCLC stage (P = 0.009), MVI (P = 0.032), AFP (P = 0.004), CTdmax (P = 0.033), and MTV (P = 0.039) were the independent predictors. The CPLC nomogram and the CPLCP nomogram were established. Compared with the CPLC nomogram, the NRI of the CPLCP nomogram increased by 38.98% (95% CI = −18.77–60.43%) and the IDI increased by 4.40% (95% CI = −1.00–16.62%). The AUC value of the CPLCP nomogram was higher than those of Milan criteria and UCSF criteria in the time-AUC curve. Moreover, the CPLCP nomogram had a higher C-index (0.774) than other models. Finally, the DCA curve showed that clinical practicability of the CPLCP nomogram outperformed the Milan criteria and UCSF criteria.

Conclusions

The CPLCP nomogram combining basic clinical data, pathology data, laboratory data, CT features, and PET metabolic parameters showed good efficacy and high clinical practicability in predicting the early recurrence of HCC after LT.

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Data availability

The datasets generated and analysed during the current study are not publicly available due to patient privacy concerns, but they are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Nuclear Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China

    Wenjie Miao, Guangjie Yang, Yangyang Wang, Lei Yan, Yujun Zhao, Mingming Yu, Fengyu Wu & Zhenguang Wang

  2. Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China

    Pei Nie

  3. Department of Gastrointestinal Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China

    Ting Yu

  4. Division of Hepatology, Liver Disease Center, Organ Transplantation Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China

    Wei Rao

  5. Institute of Transplantation Science, Qingdao University, Qingdao, Shandong, China

    Wei Rao

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  1. Wenjie Miao
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Contributions

All the authors read and approved the final manuscript.

Literature search: Wenjie Miao; Study design: Guangjie Yang, Wei Rao, Zhenguang Wang; Data collection: Yangyang Wang, Yan Lei, Yujun Zhao, Ting Yu, Mingming Yu, Fengyu Wu; Data analysis: Wenjie Miao, Guangjie Yang; Manuscript writing: Wenjie Miao; Manuscript review: Pei Nie, Guangjie Yang, Wei Rao, Zhenguang Wang.

Corresponding authors

Correspondence to Guangjie Yang, Wei Rao or Zhenguang Wang.

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Research involving human participants

All procedures performed on human participants were in accordance with the ethical standards of the Institutional Research Committee of the Affiliated Hospital of Qingdao University (Approval No. QYFY WZLL 25649) and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was waived for this retrospective study.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Oncology - Digestive tract

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Miao, W., Nie, P., Yang, G. et al. An FDG PET/CT metabolic parameter-based nomogram for predicting the early recurrence of hepatocellular carcinoma after liver transplantation. Eur J Nucl Med Mol Imaging 48, 3656–3665 (2021). https://doi.org/10.1007/s00259-021-05328-w

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