Feasibility study of ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography in proposing selection criteria for patients with hepatocellular carcinoma in liver transplantation

Abstract

To explore the feasibility of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in proposing selection criteria for patients with hepatocellular carcinoma (HCC) in liver transplantation. We respectively analyzed 31 cases of HCC patients from our hospital and those accepting no anti-tumor therapy or orthotopic liver transplantation before ¹⁸F-FDG PET/CT examination. The T/B value was set as a semi-quantitative parameter reflecting the metabolic activities of tumors. And receiver operating characteristic (ROC) curve was plotted to determine the optimal cutoff value of T/B affecting HCC recurrence after transplantation. Their clinicopathological features were analyzed by univariate and multivariate analyses to determine the risk factors for HCC recurrence after transplantation. During the follow-up period, the total incidence of tumor recurrence or metastasis was 51.6%. And the disease-free survival rates of 6 months, 1 year and 2 years post-transplantation were 93.5%, 67.7% and 46.8% respectively. The univariate analysis revealed 4 variables of affecting the recurrence or metastasis of HCC after transplantation, namely T/B value, tumor size, tumor number and preoperative alpha fetoprotein (AFP) level. While multivariate analyses indicated that T/B value and tumor size were independent factors. T/B value, tumor number and preoperative AFP level were independent risk factors for tumor recurrence. As a prognostic indicator of tumor biological behavior, ¹⁸F-FDG PET/CT can identify the eligible transplant HCC candidates.