Abstract:
AIM:The aim of this study was to retrospectively analyze the prognostic value of combined Tc-macroaggregated albumin (MAA) SPECT/CT and [F]-fluoroethylcholine (FEC) PET/CT before radioembolization for survival of patients with intermediate-stage hepatocellular carcinoma. METHODS:Twenty-four patients with known hepatocellular carcinoma Barcelona Clinic Liver Cancer stage B were eligible for this analysis. All patients were scheduled for radioembolization and received a pretherapeutic [F]FEC PET/CT scan as well as Tc-MAA SPECT/CT for hepatopulmonary shunting. Laboratory and semiquantitative PET parameters and morphologic and metabolic (intersection) volumes of MAA and FEC were evaluated. Spearman correlation with overall survival, receiver operating curve analyses, univariate and multivariate Cox regression, and Kaplan-Meier-analysis was applied. RESULTS:All patients (5 female/19 male) are deceased within the observational period. Median survival was 395 days (±51 days; range, 23-1122 days). The percentage of hypervascularized metabolically active tumor volume (vascularized tumor ratio; defined as high MAA and FEC uptake) correlated significantly with survival. Vascularized tumor ratio was a significant predictor in univariate and multivariate analyses (P = 0.026; hazard ratio, 11.65; 95% confidence interval, 1.62-83.73; P = 0.015). Statistical significance was not reached by all other variables in multivariate analysis. Receiver operating curve analysis for 1-year survival revealed an area under the curve of 0.77 (P = 0.024) for vascularized tumor ratio. At a cutoff value of 9%, sensitivity, specificity, and positive and negative prediction were 83%, 67%, and 71% and 80% (P = 0.036). Patients with a higher tumor vascularization had a median survival of 274 ± 80 versus 585 ± 284 days (P = 0.015). CONCLUSIONS:Hepatocellular carcinoma with high vascularization in metabolic active areas as assessed by combined FEC PET/CT and Tc-MAA SPECT/CT represents an unfavorable subgroup with reduced overall survival after radioembolization.
journal_name
Clin Nucl Medjournal_title
Clinical nuclear medicineauthors
Hartenbach M,Weber S,Pilz M,Hartenbach S,Zacherl MJ,Paprottka PM,Tiling R,Bartenstein P,Hacker M,Haug AR,Albert NLdoi
10.1097/RLU.0000000000002092subject
Has Abstractpub_date
2018-07-01 00:00:00pages
477-481issue
7eissn
0363-9762issn
1536-0229journal_volume
43pub_type
杂志文章abstract::Metastatic pulmonary calcification (MPC) characterized by diffuse calcium deposition in the lungs is known to occur in patients with chronic renal failure. However, MPC with pulmonary artery calcification is uncommon and has only been detected in a few patients with severe disorders. A 48-year-old man with chronic ren...
journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 临床试验,杂志文章
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
doi:10.1097/RLU.0b013e3181966fb3
更新日期:2009-03-01 00:00:00
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journal_title:Clinical nuclear medicine
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更新日期:2012-11-01 00:00:00
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journal_title:Clinical nuclear medicine
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更新日期:2008-04-01 00:00:00
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journal_title:Clinical nuclear medicine
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更新日期:2015-11-01 00:00:00
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
doi:10.1097/00003072-198308000-00009
更新日期:1983-08-01 00:00:00
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
doi:10.1097/00003072-199005000-00003
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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更新日期:2014-10-01 00:00:00
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
doi:10.1097/00003072-198803000-00012
更新日期:1988-03-01 00:00:00
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journal_title:Clinical nuclear medicine
pub_type: 杂志文章
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更新日期:2020-05-01 00:00:00