Efficiency of whole-body 18F-FDG PET CT in detecting the cause of rising serum AFP level in post-therapeutic follow-up for HCC patients.

Purpose: The goal of this study was to assess the value of whole-body F-FDG PET/CT in detecting the cause of rising serum alpha-fetoprotein (AFP) level after the treatment of hepatocellular carcinoma (HCC).

Materials And Methods: F-FDG PET/CT studies were performed for 100 patients (76 men and 24 women), ranged in age from 40 to 76 years who had underwent either surgical resection or interventional therapy for HCC, but were subsequently noted to have rising AFP serum level on routine follow-up examinations. The F-FDG PET/CT results were correlated with histological findings or radiological and clinical follow-up.

Results: According to patient-based analysis, F-FDG PET/CT demonstrated 74 true-positives, four false-negatives, 16 true-negative, and 6 false-positive results, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 95%, 72.7%, 92.5%, 80%, and 90%, respectively. According to Lesion-based analysis, F-FDG PET/CT demonstrated 202 true-positive lesions, 8 false-negatives, and 16 true-negative and 6 false-positive results, with sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of 98%, 72.7%, 97%, 80%, and 95.6%, respectively.

Conclusion: F-FDG PET/CT is a valuable imaging tool investigating patients who have a rising serum AFP level after HCC treatment. It accurately detects residual or recurrent tumor as well as extrahepatic metastasis.