Baseline and Post-treatment 18F-Fluorocholine PET/CT Predicts Outcomes in Hepatocellular Carcinoma Following Locoregional Therapy

Michael C. Wallace, Kenny Sek, Roslyn J. Francis, Shaun Samuelson, John Ferguson, Jonathan Tibballs, Ali Asad, David B. Preen, Gerry MacQuillan, George Garas, Leon A. Adams, Gary P. Jeffrey

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Abstract

Background and Aims: 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) is an emerging functional imaging technique in the diagnosis and management of hepatocellular carcinoma (HCC). The aim of this study was to assess the ability of a pre- and post-treatment 18F-FCH PET/CT to predict prognosis and treatment response in early-stage HCC. Methods: Patients with early- or intermediate-stage HCC planned for locoregional therapy were prospectively enrolled. Baseline demographic and tumor information was collected and baseline and post-treatment 18F-FCH PET/CT performed. Maximum standardized uptake values (SUVmax) were determined for each HCC lesion, and the difference between baseline and post-treatment SUVmax values were compared with progression-free survival outcomes. Results: A total of 29 patients with 39 confirmed HCC lesions were enrolled from a single clinical center. Patients were mostly men (89.7%) with hepatitis C or alcohol-related cirrhosis (65.5%) and early-stage disease (89.7%). Per-patient and per-lesion sensitivity of 18F-FCH PET/CT was 72.4% and 59.0%, respectively. A baseline SUVmax < 13 was associated with a superior median progression-free survival compared with an SUVmax of > 13 (17.7 vs. 5.1 months; p = 0.006). A > 45% decrease in SUVmax between baseline and post-treatment 18F-FCH PET/CT (“responders”) was associated with a superior mean progression-free survival than a percentage decrease of < 45% (“non-responders,” 36.1 vs. 11.6 months; p = 0.034). Conclusions: Baseline and post-treatment 18F-FCH PET/CT predicts outcomes in early-stage HCC undergoing locoregional therapy. This technique may identify patients with an objective response post-locoregional therapy who would benefit from further therapy.

Original languageEnglish
JournalDigestive Diseases and Sciences
DOIs
Publication statusE-pub ahead of print - 22 Aug 2019

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Hepatocellular Carcinoma
Therapeutics
Disease-Free Survival
fluorocholine
Hepatitis C
Fibrosis
Alcohols
Demography

Cite this

@article{07ee8525fb3b44c58ab8f4c357d7e24e,
title = "Baseline and Post-treatment 18F-Fluorocholine PET/CT Predicts Outcomes in Hepatocellular Carcinoma Following Locoregional Therapy",
abstract = "Background and Aims: 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) is an emerging functional imaging technique in the diagnosis and management of hepatocellular carcinoma (HCC). The aim of this study was to assess the ability of a pre- and post-treatment 18F-FCH PET/CT to predict prognosis and treatment response in early-stage HCC. Methods: Patients with early- or intermediate-stage HCC planned for locoregional therapy were prospectively enrolled. Baseline demographic and tumor information was collected and baseline and post-treatment 18F-FCH PET/CT performed. Maximum standardized uptake values (SUVmax) were determined for each HCC lesion, and the difference between baseline and post-treatment SUVmax values were compared with progression-free survival outcomes. Results: A total of 29 patients with 39 confirmed HCC lesions were enrolled from a single clinical center. Patients were mostly men (89.7{\%}) with hepatitis C or alcohol-related cirrhosis (65.5{\%}) and early-stage disease (89.7{\%}). Per-patient and per-lesion sensitivity of 18F-FCH PET/CT was 72.4{\%} and 59.0{\%}, respectively. A baseline SUVmax < 13 was associated with a superior median progression-free survival compared with an SUVmax of > 13 (17.7 vs. 5.1 months; p = 0.006). A > 45{\%} decrease in SUVmax between baseline and post-treatment 18F-FCH PET/CT (“responders”) was associated with a superior mean progression-free survival than a percentage decrease of < 45{\%} (“non-responders,” 36.1 vs. 11.6 months; p = 0.034). Conclusions: Baseline and post-treatment 18F-FCH PET/CT predicts outcomes in early-stage HCC undergoing locoregional therapy. This technique may identify patients with an objective response post-locoregional therapy who would benefit from further therapy.",
keywords = "F-fluorocholine, Hepatocellular carcinoma, Positron emission tomography/computed tomography",
author = "Wallace, {Michael C.} and Kenny Sek and Francis, {Roslyn J.} and Shaun Samuelson and John Ferguson and Jonathan Tibballs and Ali Asad and Preen, {David B.} and Gerry MacQuillan and George Garas and Adams, {Leon A.} and Jeffrey, {Gary P.}",
year = "2019",
month = "8",
day = "22",
doi = "10.1007/s10620-019-05781-6",
language = "English",
journal = "Digestive Diseases & Sciences",
issn = "0163-2116",
publisher = "Springer",

}

TY - JOUR

T1 - Baseline and Post-treatment 18F-Fluorocholine PET/CT Predicts Outcomes in Hepatocellular Carcinoma Following Locoregional Therapy

AU - Wallace, Michael C.

AU - Sek, Kenny

AU - Francis, Roslyn J.

AU - Samuelson, Shaun

AU - Ferguson, John

AU - Tibballs, Jonathan

AU - Asad, Ali

AU - Preen, David B.

AU - MacQuillan, Gerry

AU - Garas, George

AU - Adams, Leon A.

AU - Jeffrey, Gary P.

PY - 2019/8/22

Y1 - 2019/8/22

N2 - Background and Aims: 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) is an emerging functional imaging technique in the diagnosis and management of hepatocellular carcinoma (HCC). The aim of this study was to assess the ability of a pre- and post-treatment 18F-FCH PET/CT to predict prognosis and treatment response in early-stage HCC. Methods: Patients with early- or intermediate-stage HCC planned for locoregional therapy were prospectively enrolled. Baseline demographic and tumor information was collected and baseline and post-treatment 18F-FCH PET/CT performed. Maximum standardized uptake values (SUVmax) were determined for each HCC lesion, and the difference between baseline and post-treatment SUVmax values were compared with progression-free survival outcomes. Results: A total of 29 patients with 39 confirmed HCC lesions were enrolled from a single clinical center. Patients were mostly men (89.7%) with hepatitis C or alcohol-related cirrhosis (65.5%) and early-stage disease (89.7%). Per-patient and per-lesion sensitivity of 18F-FCH PET/CT was 72.4% and 59.0%, respectively. A baseline SUVmax < 13 was associated with a superior median progression-free survival compared with an SUVmax of > 13 (17.7 vs. 5.1 months; p = 0.006). A > 45% decrease in SUVmax between baseline and post-treatment 18F-FCH PET/CT (“responders”) was associated with a superior mean progression-free survival than a percentage decrease of < 45% (“non-responders,” 36.1 vs. 11.6 months; p = 0.034). Conclusions: Baseline and post-treatment 18F-FCH PET/CT predicts outcomes in early-stage HCC undergoing locoregional therapy. This technique may identify patients with an objective response post-locoregional therapy who would benefit from further therapy.

AB - Background and Aims: 18F-fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) is an emerging functional imaging technique in the diagnosis and management of hepatocellular carcinoma (HCC). The aim of this study was to assess the ability of a pre- and post-treatment 18F-FCH PET/CT to predict prognosis and treatment response in early-stage HCC. Methods: Patients with early- or intermediate-stage HCC planned for locoregional therapy were prospectively enrolled. Baseline demographic and tumor information was collected and baseline and post-treatment 18F-FCH PET/CT performed. Maximum standardized uptake values (SUVmax) were determined for each HCC lesion, and the difference between baseline and post-treatment SUVmax values were compared with progression-free survival outcomes. Results: A total of 29 patients with 39 confirmed HCC lesions were enrolled from a single clinical center. Patients were mostly men (89.7%) with hepatitis C or alcohol-related cirrhosis (65.5%) and early-stage disease (89.7%). Per-patient and per-lesion sensitivity of 18F-FCH PET/CT was 72.4% and 59.0%, respectively. A baseline SUVmax < 13 was associated with a superior median progression-free survival compared with an SUVmax of > 13 (17.7 vs. 5.1 months; p = 0.006). A > 45% decrease in SUVmax between baseline and post-treatment 18F-FCH PET/CT (“responders”) was associated with a superior mean progression-free survival than a percentage decrease of < 45% (“non-responders,” 36.1 vs. 11.6 months; p = 0.034). Conclusions: Baseline and post-treatment 18F-FCH PET/CT predicts outcomes in early-stage HCC undergoing locoregional therapy. This technique may identify patients with an objective response post-locoregional therapy who would benefit from further therapy.

KW - F-fluorocholine

KW - Hepatocellular carcinoma

KW - Positron emission tomography/computed tomography

UR - http://www.scopus.com/inward/record.url?scp=85071605047&partnerID=8YFLogxK

U2 - 10.1007/s10620-019-05781-6

DO - 10.1007/s10620-019-05781-6

M3 - Article

JO - Digestive Diseases & Sciences

JF - Digestive Diseases & Sciences

SN - 0163-2116

ER -