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Role of Whole Body FDG-PET in the Diagnosis of Hidden Distant Metastasis before Liver Transplantation in Patients with Primary Liver Cancer  

Lee, Won-Woo (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Ryu, Jin-Sook (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Yang, You-Jung (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Kim, Jae-Seung (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Yeo, Jeong-Seok (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Moon, Dae-Hyuk (Department of Nuclear Medicine Ulsan University of College of Medicine, Asan Medical Center)
Lee, Sung-Gyu (Department of Surgery, Ulsan University of College of Medicine, Asan Medical Center)
Publication Information
The Korean Journal of Nuclear Medicine / v.36, no.6, 2002 , pp. 368-380 More about this Journal
Abstract
Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.
Keywords
FDG-PET; Primary liver cancer; Liver transplantation;
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