Role of 18-F FDG-PET/CT in the Assessment of Extra Hepatic Metastatic Disease in Patients with Heptocellular Carcinoma (HCC) Post Hepatic Intervention, MOHAMED I. ALI, AMR O. AZAB, SHERIEF M. EL-REFAEI, MOHAMED M. HOUSENI and MAGED A. HAWANA
Abstract
Background: Hepatocellular Carcinoma (HCC) is the cause of 250,000 deaths worldwide each year. Early HCC is typically clinically silent, and the disease is often well advanced at the first manifestation.
Complete surgical resection and hepatic transplantation offer the best chance of a cure for HCC. However, surgery is often precluded by extensive disease or poor hepatic functional reserve.
Positron Emission Tomography (PET) performed with 2- [Fluorine-18] Fluoro-2-Deoxy-D-Glucose (FDG) has proved valuable in providing important tumor-related qualitative and quantitative metabolic information that is critical to diagnosis and follow-up. PET-Computed Tomography (CT) is a unique combination of the cross-sectional anatomic information provided by CT and the metabolic information provided by PET, which are acquired during a single examination and fused.
Several minimally invasive percutaneous techniques are now available to help manage localized HCC. The most used loco-regional therapy consists of imaging-guided percutaneous ethanol or thermal ablation, such as Radiofrequency Ablation (RFA) and microwave ablation, TACE, and trans-arterial radioembolization.
Many studies have indicated a greater accuracy of meta-static staging and detecting recurrent HCC by FDG-PET than by CT and other standard diagnostic modalities.
Metastatic extra hepatic lesions show focal increased FDG uptake at regional and distant lymph nodes, pulmonary nodules and bones.
Objective: The purpose of this study is to emphasis the role of combined PET/CT examination in detection of meta-static extra hepatic lesions in Heptocellular Carcinoma (HCC) post hepatic intervention.
Patients and Methods: This is a retrospective study carried out in Alfa Scan Radiology Center from March 2013 to March 2015 for in patients pathologically proven to have HCC on