Hybrid PET/CT early after treatment guides crucial decisions for many liver cancer patients

Performing PET/CT in patients with liver cancer who have already undergone treatment can help predict their response and overall survival, according to research published Wednesday.

Hepatocellular carcinoma is the fifth most common cancer worldwide. And while transarterial radioembolization treatment is gaining ground, commonly used methods to assess tumors—such as mRECIST—require longer waits before performing follow-up imaging to truly gauge TARE’s impact.

So, French experts tested if hybrid PET/CT performed 4-8 weeks after treatment could offer more timely information. And the early results are promising, first author Edouard Reizine, MD, and colleagues reported in the American Journal of Roentgenology.

“In conclusion, our study suggests that early post-TARE evaluation by PET/CT using FDG or 18F-FCH may predict six-month response and overall survival in patients with HCC,” Reizine, with HU Henri Mondor’s Department of Radiology in Val-de-Marne, France, and co-authors added. “Thus, early posttreatment PET/CT could be used to guide early response-adapted treatment decisions.”

For their retrospective investigation, the group included 37 patients with HCC treated via TARE who underwent both pretreatment FDG- and 18F-FCH-PET/CT. Each person also received FDG PET/CT and/or 18F-FCH PET/CT 4-8 weeks after treatment.

Overall, early PET/CT response showed 100% sensitivity and 100% specificity for assessing six-month mRECIST response, which uses tumor size, number and viability to analyze treatment effectiveness. At the same time, using only mRECIST criteria one month after TARE reached 67% sensitivity and 100% specificity for predicting treatment response at six months.

Additionally, hybrid PET/CT ordered 4-8 weeks after treatment proved to be highly predictive of overall survival, the authors noted.

Determining whether HCC patients should continue with their course of treatment or pivot to another approach can be a major advantage. In this study, only those with early PET/CT findings were downstaged at six months.

“Thus, earlier surgical resection might be considered after TARE in surgical candidates with early PET/CT response; in comparison, additional treatment may be offered for patients without metabolic response, without waiting for the six-month evaluation,” Reizine and colleagues explained.

Read much more from the authors here.

Around the web

The difference when using speech-recognition software may be accentuated in certain groups of radiologists, UNC researchers detailed in the Journal of Digital Imaging.

Researchers have used machine learning to track diabetes at the population level.

AI developers have worked with experts in human-computer interaction to design an EHR that shows clinicians all information pertinent to the patient case they’re working on—and only that info.

Trimed Popup
Trimed Popup