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Combined early dynamic 18F-FDG PET/CT and conventional whole-body 18F-FDG PET/CT in hepatocellular carcinoma

  • Hepatobiliary
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Abstract

Objective

To investigate the diagnostic value of early dynamic 18F-FDG PET/CT(ED 18F-FDG PET/CT) combined with conventional whole-body 18F-FDG PET/CT(WB 18F-FDG PET/CT) in hepatocellular carcinoma (HCC), as well as the difference of early dynamic blood flow parameters and maximum standardized uptake value (SUVmax) in HCC patients with/without liver cirrhosis or microvascular invasion (MVI).

Methods

Twenty-two consecutive patients (mean age 57.8 years) with 28 established HCC lesions (mean size 4.5 cm) underwent a blood flow study with an 18F-FDG dynamic scan divided into 24 sequences of 5 s each and a standard PET/CT scan. On the ED PET/CT study, an experienced PET/CT physician obtained volumes of interest (VOIs) where three blood flow estimates (time to peak [TTP], blood flow [BF], and hepatic perfusion index [HPI]) were calculated. On the WB PET/CT study, a VOI was placed on the fused scan for each HCC and maximum standardized uptake value (SUVmax) was obtained. Comparison of blood flow estimates, SUVmax, and tumor/background ratio (TNR) was performed among HCCs with and without angioinvasion, as well as HCCs in cirrhotic and non-cirrhotic liver.

Results

Compared with WB 18F-FDG PET/CT alone, ED combined with WB 18F-FDG PET/CT can significantly increase the detection rate of moderately differentiated and poorly differentiated HCCs (both P < 0.05). HPI was higher in HCCs in patients with liver cirrhosis than those without liver cirrhosis (P = 0.044). There was no significant difference in TTP, BF, SUVmax, or TNR between HCCs in patients with liver cirrhosis and those without liver cirrhosis. There was no significant difference in blood flow estimates or SUVmax in background liver parenchyma between patients with and those without cirrhosis. TTP was shorter in HCCs with MVI than without MVI (P = 0.046). There was no significant difference in BF, HPI, SUVmax, or TNR between HCCs with MVI and without MVI. There was no significant difference in blood flow estimates or SUVmax in background liver parenchyma between patients with and those without MVI.

Conclusion

ED combined with WB 18F-FDG PET/CT can significantly increase the detection rate of moderately differentiated and poorly differentiated HCCs. HPI was significantly higher in HCCs in patients with liver cirrhosis than those without liver cirrhosis. TTP was significantly shorter in HCCs with MVI than without MVI.

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Acknowledgements

This study is supported by Science and Technology Committee of Shanghai Municipality (Grant No. 20DZ2201800), the Youth Medical Talents–Medical Imaging Practitioner Program of Shanghai “Rising Stars of Medical Talent” Youth Development Program (SHWRS (2020)_087), Special Fund for Clinical Research of Zhongshan Hospital, Fudan University (2020ZSLC63), and Shanghai Municipal Key Clinical Specialty (shslczdzk03401).

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Author notes

  1. Beilei Li and Hongcheng Shi have equally contributed to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China

    Yiqiu Zhang, Shuguang Chen, Haojun Yu & Hongcheng Shi

  2. Department of Nuclear Medicine, Zhongshan Hospital（Xiamen), Fudan University, Xiamen, Fujian, China

    Yiqiu Zhang, Beilei Li & Hongcheng Shi

  3. Nuclear Medicine Institute of Fudan University, Shanghai, China

    Yiqiu Zhang, Shuguang Chen, Haojun Yu, Beilei Li & Hongcheng Shi

  4. Shanghai Institute of Medical Imaging, Shanghai, China

    Yiqiu Zhang, Shuguang Chen, Haojun Yu, Beilei Li & Hongcheng Shi

  5. Shanghai United Imaging Healthcare Co., Ltd., Shanghai, China

    Yun Dong & Wenjun Yu

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  1. Yiqiu Zhang
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  3. Wenjun Yu
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Correspondence to Beilei Li or Hongcheng Shi.

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Zhang, Y., Dong, Y., Yu, W. et al. Combined early dynamic 18F-FDG PET/CT and conventional whole-body 18F-FDG PET/CT in hepatocellular carcinoma. Abdom Radiol 48, 3127–3134 (2023). https://doi.org/10.1007/s00261-023-03986-y

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  • DOI: https://doi.org/10.1007/s00261-023-03986-y

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