[Evaluating efficacy of transcatheter arterial chemo-embolization combined with radiofrequency ablation on patients with hepatocellular carcinoma by 18FDG-PET/CT].

BACKGROUND & OBJECTIVE: Judging tumor residue of hepatocellular carcinoma (HCC) after treatment of transcatheter arterial chemo-embolization (TACE) combined with radiofrequency ablation (RFA) by computed tomography (CT) scan is difficult; while 18-fluorodeoxyglucose-positron emission tomography/CT ((18)FDG-PET/CT) has some advantages in this aspect. This study was designed to compare the results of (18)FDG-PET/CT and CT scan in judging tumor residue of HCC after treatment of TACE combined with RFA, and to guide following treatment according to the result of (18)FDG-PET/CT. METHODS: Thirteen HCC patients with 18 lesions, 0.8-16.0 cm in diameter, were treated in Cancer Center of Sun Yat-sen University from Nov. 2002 to Jun. 2003. Of the 13 patients, 12 were naive patients with 15 lesions; 1 was relapsed with 3 lesions 1 year after hepatectomy. The results of CT and (18)FDG-PET/CT of the 13 patients 2-3 weeks after treatment of TACE combined with RFA were compared. If tumor residue was dictated, a further RFA treatment would be applied within 2-3 weeks. RESULTS: Of the 13 HCC patients that received 1 course of TACE combined with RFA, 11 had tumor residues which were conformed by fine needle biopsy and digital substraction angiography (DSA). CT only detected 5 positive cases; however, (18)FDG-PET/CT detected 10 positive cases. Positive rate of CT was 45.4%, and that of (18)FDG-PET/CT was 90.9%. According to the results of (18)FDG-PET/CT of the 11 patients, after the second course of RFA, 10 patients had no tumor residue; 1 patient survived with uncontrolled lesion 6 weeks after treatment. CONCLUSION: (18)FDG-PET/CT is better than CT in judging tumor residue of HCC after treatment of TACE combined with RFA or surgery, and in guiding further treatment of HCC.