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The added value of 18F-FDG PET/MRI multimodal imaging in hepatocellular carcinoma for identifying cytokeratin 19 status

  • Hepatobiliary
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Abstract

Purpose

In hepatocellular carcinoma (HCC), cytokeratin 19(CK19) has been proven to be associated with clinical aggressiveness. Therefore, this study aimed to explore the added value of 18F-FDG PET/MRI in predicting CK19 status in HCC.

Methods

Sixty-six patients who underwent whole-body or abdominal 18F-FDG PET/MRI after conventional PET/CT for HCC were retrospectively enrolled. The maximal standard uptake value (T-SUVmax) and the mean apparent diffusion coefficient (T-ADCmean) of the tumor (T), as well as those of the normal liver tissues (L) were derived, followed by calculations of the T-SUVmax/L-SUVmax (SUVmax-T/L) and the T-ADCmean/L-ADCmean (ADCmean-T/L) ratios. Combined with the postoperative pathological results, the performance in predicting the CK19 status in HCC was evaluated using receiver operating characteristic analysis (ROC).

Results

The areas under the ROC curve (AUCs) for T-SUVmax, SUVmax-T/L, T-ADCmean, and ADCmean-T/L in predicting the CK19-positive HCC were 0.700, 0.717, 0.717, and 0.735, respectively. In the logistic regression analysis, the T-SUVmax was an independent and significant factor to predict CK19-positive HCC, with an odds ratio of 1.27. In addition, no significant differences were found in the pathological grading, microvascular invasion, liver capsular invasion, Hepatitis B virus (HBV) infection, alpha fetoprotein (AFP) level, and tumor diameter between the CK19-positive and CK19-negative groups, except the recurrent rate.

Conclusions

The radiomic features derived from 18F-FDG PET/MRI can be used to predict the CK19 status of HCC. T-SUVmax and T-ADCmean were significant indicators, whereas T-SUVmax was an independent predictor.

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Funding

This study was supported by The National Natural Science Foundation of China, 82001863 and The Shanghai Sailing Program, 19YF1408200.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, China

    Jing Lv, Hongyan Yin, Haojun Yu & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, 200032, China

    Jing Lv, Hongyan Yin, Haojun Yu & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, 200032, China

    Jing Lv, Hongyan Yin, Haojun Yu & Hongcheng Shi

Authors
  1. Jing Lv
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  2. Hongyan Yin
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  3. Haojun Yu
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Contributions

JL and HS: participated in research design and writing the paper. JL and HY and HY: participated in the data analysis. JL and HS: participated in performance of the research.

Corresponding author

Correspondence to Hongcheng Shi.

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Conflict of interest

All authors declare that they have no competing interests.

Ethical approval

This study was approved by the Ethics Committee of Zhongshan Hospital, Fudan University and conducted in strict accordance to the Declaration of Helsinki proposed in 1975 and revised in 2000. Written informed consent of each patient was obtained before the imaging.

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Lv, J., Yin, H., Yu, H. et al. The added value of 18F-FDG PET/MRI multimodal imaging in hepatocellular carcinoma for identifying cytokeratin 19 status. Abdom Radiol 48, 2331–2339 (2023). https://doi.org/10.1007/s00261-023-03911-3

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  • DOI: https://doi.org/10.1007/s00261-023-03911-3

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