Incidental findings on FDG-PET/CT in HCC patients – relevant information for patients considered for liver transplantation?

Ziel/Aim FDG-PET/CT has been described for non-invasive grading, detection of extrahepatic spread and recurrence in HCC. As compared to localized imaging approaches (MRI, ultrasonography), FDG-PET/CT not only focusses on the liver, but covers a long field of view from the base of the skull to the thighs, visualizing pathologic findings not related to HCC. The aims of this retrospective study were to 1) describe the frequency of relevant incidental findings on FDG-PET/CT in HCC patients; 2) evaluate the impact on treatment strategy in HCC patients considered for liver transplantation; and 3) to discuss the role of FDG-PET/CT in patients considered for transplantation in general.

Methodik/Methods 439 FDG-PET/CT examinations of 345 HCC patients were screened for incidental findings. The clinical information system was searched for examinations performed after FDG-PET/CT and aimed at verification of incidental findings. Of 345 HCC patients, 81 patients were considered for liver transplantation. The impact of incidental findings was recorded separately for this subgroup.

Ergebnisse/Results 101 patients with incidental findings in 439 FDG-PET/CT examinations were identified. The incidental findings comprised 22 neoplasms (9 malignant) and 52 inflammations. Liver transplantation was not performed due to an incidental finding on FDG-PET/CT in 9/81 (11.1 %) patients.

Schlussfolgerungen/Conclusions FDG-PET/CT is capable of identifying relevant incidental findings (i.e. secondary malignancy, benign tumors and inflammation) in HCC patients and HCC patients considered for liver transplantation und thus, influencing HCC patient management. FDG-PET/CT might also be beneficial in patients considered for transplantation of different organs.

Publication History

Article published online:
08 April 2021