Evaluation of 11C-Acetate and 18F-FDG PET Scan with contrast CT on pathological and prognosis prediction in HCC Patients before Liver Transplantation - a Single-Institute Experience

Abstract

BACKGROUND: The sensitivity of contrast CT scan and MRI for HCC staging is far from satisfactory. We investigated whether contrast computed tomography (CT) together with position emission tomography (PET) using two tracers, 11C-acetate and 18F-FDG, provides a more accurate staging by comparing directly to the liver explants. METHOD: Data of 80 HCC patients having the dual-tracer PET together with contrast CT before surgery between January 2004 and October 2013 were reviewed. 26 underwent deceased donor liver transplantation and 54 underwent live donor liver transplantation. Results of preoperative HCC staging were compared with pathological results after surgery. RESULTS: Total 124 tumours were identified. The median tumour number were 1 (1-4) and the median size was 3.5cm (0.3-8.0). The overall accurate predication of final pathology in terms of UCSF criteria by contrast CT scan alone was 40/76 (52.6%), by FDG alone was 19/76 (25.0%), by C acetate alone 59/76 (77.6%) and by overall combination of 3 assessment was 60/76 (78.9%) (p2cm the respective sensitivity was 44/68 (64.7%), 23/68 (33.8%), 54/68 (79.4%) and 59/68 (86.8%) respectively (p<0.05). CONCLUSION: Dual tracer PET/CT has very high accuracy in HCC predictions. It may also provide prognostic indicators for patient receiving liver transplant.