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Tytuł:
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The role of (18)F-FDG-PET imaging for the selection of liver transplantation candidates among hepatocellular carcinoma patients.
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Autorzy:
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Yang SH; Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Suh KS
Lee HW
Cho EH
Cho JY
Cho YB
Yi NJ
Lee KU
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Źródło:
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Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society [Liver Transpl] 2006 Nov; Vol. 12 (11), pp. 1655-60.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: 2023- : [Philadelphia] : Wolters Kluwer Health, Inc.
Original Publication: Philadelphia, PA : W.B. Saunders Co., c2000-
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MeSH Terms:
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Fluorodeoxyglucose F18*
Liver Transplantation*
Patient Selection*
Positron-Emission Tomography*
Radiopharmaceuticals*
Carcinoma, Hepatocellular/*surgery
Liver Neoplasms/*surgery
Adult ; Aged ; Blood Vessels/pathology ; Carcinoma, Hepatocellular/blood ; Carcinoma, Hepatocellular/diagnostic imaging ; Carcinoma, Hepatocellular/pathology ; Female ; Humans ; Liver/blood supply ; Liver/pathology ; Liver Neoplasms/blood ; Liver Neoplasms/diagnostic imaging ; Liver Neoplasms/pathology ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Survival Analysis ; alpha-Fetoproteins/metabolism
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Substance Nomenclature:
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0 (Radiopharmaceuticals)
0 (alpha-Fetoproteins)
0Z5B2CJX4D (Fluorodeoxyglucose F18)
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Entry Date(s):
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Date Created: 20060912 Date Completed: 20070130 Latest Revision: 20220316
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Update Code:
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20240104
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DOI:
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10.1002/lt.20861
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PMID:
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16964589
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Positron emission tomography (PET) using F-18 fluoro-2-deoxy-d-glucose ((18)F-FDG) is now well established as a noninvasive diagnostic tool for the detection of a variety of malignant tumors. However, in the case of hepatocellular carcinoma (HCC), several investigators have reported controversial conclusions and an inadequate sensitivity for PET (50-55%). Nevertheless, a high positive rate of (18)F-FDG accumulation has been reported in patients with high-grade HCC and in those with markedly elevated alpha-fetoprotein (AFP) levels. Here, we retrospectively reviewed 38 HCC cases that received liver transplantation (LT) at our center between November 2000 and July 2004 and underwent whole-body PET imaging. (18)F-FDG uptake was assessed in the liver, and its prognostic significance was investigated. Of 38 patients enrolled, 13 patients had positive PET scans for a liver tumor. When we analyzed the association between tumor factors and PET+ (greater PET lesion uptake) in the liver, preoperative AFP level and vascular invasion were found to be significantly associated with PET+ (P = 0.003 and P < 0.001, respectively). However, the association between histological grade and PET+ findings did not reach statistical significant difference (P = 0.074). Moreover, the 2-year recurrence-free survival rate of PET- patients was significantly higher than that of PET+ patients (85.1% vs. 46.1%) (P = 0.0005). Of 6 PET+ patients who met the Milan criteria, 4 patients (66.7%) had recurrence, but all 20 PET- patients who met the Milan criteria were recurrence free. Thus, PET imaging could be a good preoperative tool for estimating the post-LT risk of tumor recurrence, because histological grade and vascular invasion cannot be determined preoperatively. Importantly, our results indicate that tumor recurrence can be highly anticipated for PET-imaging-positive HCC patients who satisfy the Milan criteria. We advise that PET+ HCC patients be selected cautiously for LT.
((c) 2006 AASLD)
Erratum in: Liver Transpl. 2007 Jan;13(1):175.