Detection of Primary Hepatocellular Carcinoma on 18F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography

Kiran Arshad; Sheikh Danial Hanan; Muhammad Numair Younis; Rimsha Badar; Minahil Imran; Nefal Numair; Abubakar Imran

doi:10.5005/jp-journals-10018-1409

Detection of Primary Hepatocellular Carcinoma on ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography

Euroasian J Hepatogastroenterol. 2023 Jul-Dec;13(2):66-72. doi: 10.5005/jp-journals-10018-1409.

Authors

Kiran Arshad¹, Sheikh Danial Hanan², Muhammad Numair Younis³, Rimsha Badar¹, Minahil Imran⁴, Nefal Numair⁵, Abubakar Imran¹

Affiliations

¹ Department of Allied Health Sciences, Fatima Memorial Hospital, Lahore, Punjab, Pakistan.
² Department of Medical Imaging Technology, NUR International University, Lahore, Punjab, Pakistan.
³ Department of Nuclear Medicine and PET Imaging, Institute of Nuclear Medicine and Oncology (INMOL), Lahore, Punjab, Pakistan.
⁴ East Lancashire Hospitals NHS Trust, Lancashire, United Kingdom.
⁵ Shaikh Khalifa Bin Zayed Al-Nahyan Medical and Dental College, Lahore, Punjab, Pakistan.

Abstract

Aims and background: Hepatocellular carcinoma (HCC), ranks as the third most prevalent malignancy contributing to cancer-related death on a global scale. Hepatocellular carcinoma is known to be the fifth most frequently diagnosed malignancy of the males while among females, it is ranked as the seventh most common malignancy. The study was conducted to detect the sensitivity of primary HCC using ¹⁸F-flourodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) scan.

Materials and methods: This prospective study was conducted to identify the primary HCC in a sample size of 51 patients, in whom FDG PET-CT scan was performed between May 2022 and December 2022.

Results: Among the cohort of 51 patients, primary HCC was detected on FDG PET-CT in 43 individuals representing true-positive cases. Conversely, FDG PET-CT was unable to detect HCC in 8 cases, representing false-negative. Out of 51 patients, 74.5% of HCC cases exhibited multifocal pattern. The maximum standardized uptake value (SUV max) of the primary malignant site ranged from 1.9 to 16.1, with a mean of 3.7 ± 2.8. The FDG PET-CT revealed abnormal sites of the uptake outside liver in 23 individuals. The research confirmed the tumor recurrence in four previously treated patients. In the conducted investigation, FDG PET-CT showed 84.3% sensitivity for the diagnosis of HCC.

Conclusion: The study demonstrates that FDG PET-CT is a viable option for the detection of HCC. The sensitivity of FDG PET-CT in our population is comparable and in agreement with international data for diagnosis of HCC thereby favoring its reproducibility among geographical and ethnic groups. However, owing to the reduced ability of FDG PET-CT scan to identify well-differentiated/low-grade HCC, the routine use of FDG PET-CT scan may not be considered in cases requiring evaluation of primary disease only.

How to cite this article: Arshad K, Hanan SD, Younis MN, et al. Detection of Primary Hepatocellular Carcinoma on ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography. Euroasian J Hepato-Gastroenterol 2023;13(2):66-72.

Keywords: 18F-flourodeoxyglucose positron emission tomography-computed tomography; Computed tomography; Hepatocellular carcinoma; Sensitivity.