Value of 18F-FDG-PET/CT in the detection of recurrent hepatocellular carcinoma after hepatectomy or radiofrequency ablation: A comparative study with contrast-enhanced ultrasound

Abstract

Objective: To evaluate the role of positron emission tomography/computer tomography with fluorine-18 fluorodeoxyglucose (18F-FDG-PET/CT) in detecting hepatocellular carcinoma (HCC) recurrence after hepatectomy and/or radiofrequency ablation (RFA) and to compare its efficacy with contrast-enhanced ultrasound (CEUS). Methods: A total of 36 HCC patients were included in this study. All patients underwent both 18F-FDG-PET/CT and CEUS at least once for the diagnosis of HCC recurrence. The time interval between PET/CT and CEUS was 14±3 days. All patients were followed up for at least 24 months. Results: In all, 32 patients were confirmed to have HCC recurrence by pathology and clinical follow-up. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 18F-FDG-PET/CT for intrahepatic HCC recurrence were 96.7%, 83.3%, 96.7%, 83.3% and 94.4%, respectively. The corresponding values of CEUS were 56.7%, 100%, 100%, 31.6% and 63.9%, respectively. The sensitivity and accuracy of 18F-FDG-PET/CT for the diagnosis of HCC recurrence were significantly higher than those of CEUS (P<0.01, respectively). Conclusions: Compared with CEUS, 18F-FDG-PET/CT has higher sensitivity and accuracy in detecting the local recurrence of HCC after hepatectomy and/or RFA. It can be used to detect recurrent extrahepatic lesions of HCC effectively. © 2013 Wiley Publishing Asia Pty Ltd and Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine.