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Value of 18F-FDG PET/CT in the diagnosis of portal vein tumor thrombus in patients with hepatocellular carcinoma

  • Hepatobiliary
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to evaluate the usefulness of 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) for the diagnosis of a portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma (HCC).

Methods

One hundred fifty-four patients with histologically proven HCC underwent 18F-FDG PET/CT imaging. The maximum standardized uptake value (SUVmax) was calculated, and the change in SUVmax (retention index, RI) was defined as the ratio of the increase in SUVmax between early and delayed scans to the SUVmax in the early scan. The circular region of interest was placed on the transaxial images according to the corresponding CT images. The final diagnoses of a PVTT were confirmed by histopathology.

Results

Of the patients examined, 101 (65.6%) had no confirmed instances of a PVTT, whereas 53 (34.4%) had a confirmed PVTT. The sensitivity of 18F-FDG PET/CT imaging was 62.3%, the specificity was 97.0%, the accuracy was 85.1%, the positive predictive value was 91.7%, and the negative predictive value was 83.1%. The SUVmax of the PVTT was 4.32 ± 1.96 and the SUVmax of the HCC lesions for these patients was 5.38 ± 2.79, but these differences were insignificant (t = 1.78, p = 0.08). For dual-time-point imaging, the SUV1 of the PVTT lesions was 3.75 ± 1.48, and SUV2 was 3.63 ± 1.41, but these differences were insignificant (t = 0.82, p = 0.42). The SUV1 of the HCC lesions was 4.47 ± 2.03, and the SUV2 was 4.90 ± 2.07, which were both also insignificant (t = − 1.81, p = 0.09). The RI of the PVTT lesions was − 2.05 ± 19.96%, and the RI of the HCC lesions was 11.87 ± 26.20%, with no significant differences between them (t = 1.58, p = 0.13).

Conclusions

18F-FDG PET/CT may potentially improve the accurate diagnoses of a PVTT in patients with HCC.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, No. 180, Fenglin Road, Xuhui District, Shanghai, China

    Bing Wu, Yiqiu Zhang, Hui Tan & Hongcheng Shi

  2. Nuclear Medicine Institute of Fudan University, Shanghai, China

    Bing Wu, Yiqiu Zhang, Hui Tan & Hongcheng Shi

  3. Shanghai Institute of Medical Imaging, Shanghai, China

    Bing Wu, Yiqiu Zhang, Hui Tan & Hongcheng Shi

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  1. Bing Wu
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  2. Yiqiu Zhang
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  3. Hui Tan
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  4. Hongcheng Shi
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Correspondence to Hongcheng Shi.

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Wu, B., Zhang, Y., Tan, H. et al. Value of 18F-FDG PET/CT in the diagnosis of portal vein tumor thrombus in patients with hepatocellular carcinoma. Abdom Radiol 44, 2430–2435 (2019). https://doi.org/10.1007/s00261-019-01997-2

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  • DOI: https://doi.org/10.1007/s00261-019-01997-2

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