The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

Jeong Won Lee; Mijin Yun; Arthur Cho; Kwang Hyub Han; Do Young Kim; Sang Mi Lee; Jong Doo Lee

doi:10.1007/s12149-015-0956-8

The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

Jeong Won Lee, Mijin Yun, Arthur Cho, Kwang Hyub Han, Do Young Kim, Sang Mi Lee, Jong Doo Lee

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

Abstract

Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV_2SD, defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (T_max/L_mean) was also calculated. The prognostic significance of MTV2SD and T_max/L_mean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, T_max/L_mean, and MTV_2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, T_max/L_mean, and MTV_2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV_2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

Original language	English
Article number	A001
Pages (from-to)	400-408
Number of pages	9
Journal	Annals of Nuclear Medicine
Volume	29
Issue number	5
DOIs	https://doi.org/10.1007/s12149-015-0956-8
Publication status	Published - 2015 Jun 1

Bibliographical note

Funding Information:
This work was supported by research fund of Catholic Kwandong University International St. Mary’s Hospital.

Publisher Copyright:
© The Japanese Society of Nuclear Medicine 2015.

All Science Journal Classification (ASJC) codes

Radiology Nuclear Medicine and imaging

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Lee, J. W., Yun, M., Cho, A., Han, K. H., Kim, D. Y., Lee, S. M., & Lee, J. D. (2015). The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis. Annals of Nuclear Medicine, 29(5), 400-408. Article A001. https://doi.org/10.1007/s12149-015-0956-8

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title = "The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis",

abstract = "Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV2SD, defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (Tmax/Lmean) was also calculated. The prognostic significance of MTV2SD and Tmax/Lmean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, Tmax/Lmean, and MTV2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, Tmax/Lmean, and MTV2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.",

author = "Lee, {Jeong Won} and Mijin Yun and Arthur Cho and Han, {Kwang Hyub} and Kim, {Do Young} and Lee, {Sang Mi} and Lee, {Jong Doo}",

note = "Funding Information: This work was supported by research fund of Catholic Kwandong University International St. Mary{\textquoteright}s Hospital. Publisher Copyright: {\textcopyright} The Japanese Society of Nuclear Medicine 2015.",

year = "2015",

month = jun,

day = "1",

doi = "10.1007/s12149-015-0956-8",

language = "English",

volume = "29",

pages = "400--408",

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Lee, JW, Yun, M, Cho, A, Han, KH , Kim, DY, Lee, SM & Lee, JD 2015, 'The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis', Annals of Nuclear Medicine, vol. 29, no. 5, A001, pp. 400-408. https://doi.org/10.1007/s12149-015-0956-8

The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis. / Lee, Jeong Won; Yun, Mijin; Cho, Arthur et al.
In: Annals of Nuclear Medicine, Vol. 29, No. 5, A001, 01.06.2015, p. 400-408.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

AU - Lee, Jeong Won

AU - Yun, Mijin

AU - Cho, Arthur

AU - Han, Kwang Hyub

AU - Kim, Do Young

AU - Lee, Sang Mi

AU - Lee, Jong Doo

N1 - Funding Information: This work was supported by research fund of Catholic Kwandong University International St. Mary’s Hospital. Publisher Copyright: © The Japanese Society of Nuclear Medicine 2015.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV2SD, defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (Tmax/Lmean) was also calculated. The prognostic significance of MTV2SD and Tmax/Lmean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, Tmax/Lmean, and MTV2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, Tmax/Lmean, and MTV2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

AB - Objective The aim of this study was to evaluate the prognostic value of metabolic tumor volume (MTV) on pre-treatment F-18 fluorodeoxyglucose (FDG) PET/CT in patients with hepatocellular carcinoma (HCC). Methods A total of 59 HCC patients who underwent FDG PET/CT before transarterial chemoembolization (TACE) or transarterial chemotherapy infusion (TACI) were retrospectively enrolled. The region of interest was drawn in the HCC and normal liver tissue. MTV2SD, defined as the sum of the voxels with higher standardized uptake values (SUV) than the SUV of the 97.5th percentile of voxels of the normal liver for each patient, was calculated using an intensity– volume histogram (IVH). The ratio of the maximum SUV of the tumor to the mean SUV of normal liver (Tmax/Lmean) was also calculated. The prognostic significance of MTV2SD and Tmax/Lmean for progression-free survival (PFS) and overall survival (OS) was evaluated along with other clinical factors. Results The tumor number, Tmax/Lmean, and MTV2SD were significant prognostic factors affecting PFS (p<0.05), whereas tumor number, serum alpha-fetoprotein level, tumor stage, portal vein thrombosis, Tmax/Lmean, and MTV2SD were significant prognostic factors for OS (p<0.05). In multivariate analysis, the tumor number and MTV2SD were independent prognostic factors for PFS (p<0.05), whereas the independent prognostic factors for OS were tumor number, tumor stage, and MTV2SD (p<0.05). The mean PFS and OS in patients with low MTV2SD (15.4 and 63.1 months, respectively) were significantly longer than those in patients with high MTV2SD (6.0 and 15.2 months, respectively; p = 0.005 and p<0.0001, respectively). Conclusions Metabolic tumor volume was an independent prognostic factor for PFS and OS in patients with HCC. Therefore, FDG PET/CT can provide valuable prognostic information for HCC patients who undergo TACE or TACI.

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The predictive value of metabolic tumor volume on FDG PET/CT for transarterial chemoembolization and transarterial chemotherapy infusion in hepatocellular carcinoma patients without extrahepatic metastasis

Abstract

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