HCC (Hepato-cellular Carcinoma) is the fifth most frequent cancer in humans and its
prevalence is growing. The most effective treatment of HCC is surgical and includes resection
and liver transplantation; however, only 20% of the patients can be treated surgically. Local
interventional therapy, such as radiofrequency (RF) ablation and transarterial embolization
is also used.
Recurrence rate is very high, and extrahepatic disease develops in about 30% of the cases and
in up to 20% after liver transplantation.
Systemic treatment is thus an option. Sorafenib (multi-kinase inhibitor) is the first agent
to significantly improve the overall survival in advanced HCC. However, the drug has serious
side effects and is very expensive.
PET/CT with F18-FDG is a common tool for systemic evaluation and staging of various tumors.
The value of the FDG PET for evaluation of HCC is controversial, in particular due to the
unique metabolic pathway of glucose in the HCC cells. Since 2007 more and more studies
suggest the feasibility of FDG PET/CT for monitoring local recurrence (especially after RF)
and metastatic spread of HCC, including detection of active disease only suspected by AFP
Early detection of treatment response to therapy by whole body FDG PET/CT allows for change
of treatment as early as possible,when the tumor is non-responsive before serious side
effects appear or before depletion of body resources.
The aim of our study is to investigate the contribution of FDG PET/CT to assessment of