FDG-PET as a prognostic predictor in the early therapeutic evaluation of the non-operative treatment of hepatocellular carcinoma

1737 Objectives To investigate the diagnostic and predictive value of FDG-PET in the early therapeutic evaluation of non-operative treatment for patients with hepatocellular carcinoma (HCC). Methods Sixty-seven patients with HCC received non-operative treatment (Transarterial chemoembolization/ TACE: n=24, Transarterial infusion chemotherapy/ TAI: n=31, Radiofrequancy ablation/ RFA: n=5, systemic chemotherapy:n=7) and FDG-PET for the evaluation of the treatment effect within one month of the end of the therapy. Viability of tumor was evaluated qualitatively and quantitatively using maximum standardized uptake value (SUV). Final diagnosis was confirmed by surgical resection or by clinical follow-up (>6months). Results Overall diagnostic value of PET was relatively low for hepatic lesions (sensitivity/ specificity/ accuracy: 63%, 96%, 75%), while relatively high for extrahepatic metastatic lesions (79%, 92%, 87%). Long-term follow-up revealed that low FDG-avid group (SUV=2.5±0.9)(stage I-III: n=16, IV: n=11) showed significantly longer survival than high FDG-avid group (SUV=6.8±4.2)(stage I-III: n=21, IV: n=19)(p Conclusions Post-therapeutic FDG-PET performed within one month can be a good predictor of survival in HCC patients. Possibility of false negative PET results is to be noted in the early therapeutic evaluation of viability of HCC, especially in hepatic lesions.