CHARACTERISTICS OF FDG PET/CT IN TREATED HEPATOCELLULAR CARCINOMA WITH HIGH LEVELS OF PIVKA-II OR AFP-L3
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Abstract
Objective: Many diagnostic imaging modalities are used in follow-up of treated hepatocellular carcinoma (HCC). The aim of this study is to investigate characteristics of FDG PET/CT in follow-up of treated HCC with elevated levels of PIVKA-II or AFP-L3.
Patients and methods: A retrospective study analyzed treated HCC patients who had PIVKA-II >40 mAU/ml or AFP-L3 >10% and underwent FDG PET/CT with dynamic CT. We investigated PET/CT imaging characteristics in correlation with serum PIVKA-II and AFP-L3.
Results: FDG PET/CT detected lesions in 42 of 48 patients (87.5 %), including hepatic lesions in 16 (33,3 %), extrahepatic lesions in 10 (20,8 %) and both in 16 patients (33,3 %). 26 of 48 patients (54,2 %) had extrahepatic lesions: lung (31.2 %), distal lymph node (16.6 %), peritoneum (8,3 %), regional lymph node (6.2 %), bone (6.2 %) and adrenal gland (2.1 %).
Mean AFP-L3 value was 40,6 % in group of patients with lesions in PET/CT and 11.7 % in patients without lesions (p = 0.02). There was no difference on PIVKA-II value between both groups.
Conclusion: In patients with treated HCC with high serum concentration of PIVKA-II or AFP-L3, FDG PET/CT played an important role in detection of lesions. The indication for FDG PET/CT should be considered when negative conventional imaging or to further evaluate and find out further lesions.
Keywords
Hepatocellular cancer (HCC), PET/CT (Positron Emission Tomography/ Computed Tomography), FDG (F-18 Fluorodeoxyglucose), PIVKA-II and AFP-L3
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References
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