Metabolic activity assessment by 18F‐fluorodeoxyglucose positron emission tomography in patients with hepatocellular carcinoma undergoing Yttrium‐90 transarterial radioembolization

Background and Aim 18F‐fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) is a functional image technique that can inform clinical decisions related to prognosis. We investigated the predictive role of 18F‐fluorodeoxyglucose PET/CT in patients with hepatocellular carcinoma (HCC) undergoing Yttrium‐90 (Y‐90) transarterial radioembolization (TARE). Methods Patients with HCC treated with TARE and pre‐TARE PET/CT scan were recruited between 2009 and 2013. Maximum standardized uptake value and tumor‐to‐non‐tumorous liver uptake ratio (TLR) were measured. Tumor response was evaluated in accordance with modified RECIST criteria at 3‐month intervals after Y‐90 TARE. Results Forty patients were included in the final analysis. The median age was 56.5 years and male predominant. Disease control in treated lesion was achieved in 82.5% (n = 33) of patients. During median 18.3‐month follow‐up, 27.5% (n = 11) of patients achieved progression‐free survival. The cutoff of TLR, which was related to the median value, did not affect disease control rate, progression‐free survival, and overall survival in patients with Y‐90 TARE. Conclusions The TLR‐based stratification may be a simple method, but our study did not show the usefulness in predicting prognosis in HCC patients with Y‐90 TARE. Further studies with large number of patients are needed.