Diagnostic Accuracy of <sup>18</sup>F-FDG Positron Emission Tomography for Evaluation of Hepatocellular Carcinoma

Korean J Hepatol > Volume 12(4); 2006 > Article

The Korean Journal of Hepatology 2006;12(4): 546-552.

Diagnostic Accuracy of ¹⁸F-FDG Positron Emission Tomography for Evaluation of Hepatocellular Carcinoma

Jeong A Shin , Joong Won Park , Min An , Joon Il Choi , Seong Hoon Kim , Seok Ki Kim , Woo Jin Lee , Sang Jae Park , Eun Kyung Hong , Chang Min Kim

Center for Liver Center, Department of Nuclear Medicine1 National Cancer Center, Korea

ABSTRACT

Background/Aims
Positron emission tomography (PET) is an imaging technique reflecting cellular metabolism. However, the feasibility of PET in the diagnosis of hepatocellular carcinoma (HCC) is limited because of vague accuracy and high cost. The aim of this study was to evaluate the diagnostic accuracy of ¹⁸F-FDG-PET in detection of HCC. Methods: We retrospectively studied HCC patients who underwent ¹⁸F- FDG-PET between June 2001 and February 2005 in Korea National Cancer Center. Thirty-two patients were enrolled and HCC status of these patients were verified by surgical pathology or clinical course using imaging studies (CT, MRI or angiography) within 3 months after PET. PET studies were read by 2 specialists for nuclear medicine and determined as malignant when its standardized uptake value (SUV) was over 2.5. Results: HCC was suspected in 21 out of 32 cases on ¹⁸F-FDG-PET. On follow-up, 2 of 21 cases were determined false-positive. In cases of 11 patients without evidence of HCC on ¹⁸F-FDG-PET, 10 patients were found to have HCC on follow-up. Thus, the sensitivity and specificity of ¹⁸F-FDG-PET were 65.5% and 33.3% respectively. The positive predictive value was 90.5%. The diagnostic accuracy was 62.5%. Conclusion: ¹⁸F- FDG-PET showed a low accuracy in diagnosis of HCC. Therefore, ¹⁸F-FDG-PET has a limited role in a staging and detection of occult HCC. (Korean J Hepatol 2006;12:546-552)

KeyWords: Carcinoma, hepatocellular; Liver neoplasms; Positron-emission tomography; Diagnosis; 18F-FDG