ArticleJHEP reports : innovation in hepatology2024
Dual-tracer PET/CT in the management of hepatocellular carcinoma.
Article in JHEP reports : innovation in hepatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- [European journal of nuclear medicine and molecular imaging · 2025Trial
- Limited Added Prognostic Value of Choline PET/CT in Treatment-Naïve Hepatocellular Carcinoma.World journal of nuclear medicine · 2026Article
- Real-world evidence in a large cohort comparing FAPI and FDG PET/CT for hepatopancreatobiliary cancer diagnosis.European journal of nuclear medicine and molecular imaging · 2026Article
- Prognostic Value ofCancers · 2026Article
- The Crosstalk Mechanisms Between Ferroptosis and Pyroptosis and Their Applications in Diseases: From Molecular Networks to Clinical Strategies.Journal of cellular and molecular medicine · 2026Review
- Advances in galactose-based small-molecule hepatocyte-targeting probes for detecting biomarkers in hepatocellular carcinoma.Frontiers in chemistry · 2026Review
- ACSS1 co-opts acetyl-CoA metabolism to drive DNA repair and undermine radiotherapy efficacy in breast cancer.Cell death & disease · 2025Article
- Diagnostic significance of fluorine-18-fluorodeoxyglucose-positron emission tomography/computed tomography in differentiating Edmondson grade II and III hepatocellular carcinoma.World journal of gastrointestinal surgery · 2025Article
- Expert survey on systemic therapy indications for hepatocellular carcinoma in Korea: bridging clinical practice and reimbursement criteria.Journal of liver cancer · 2025Article
- Development of a Cyclic TMTP1-Based PET Probe for Visualization of Hepatocellular Carcinoma.ACS medicinal chemistry letters · 2025Article
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16 authors.
Funding
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Abstract
Background & Aims: Combined Methods: We retrospectively assessed 525 consecutive patients from three tertiary centers between 2014 and 2020. For staging, we recorded new lesion detection rates, changes in the Barcelona Clinic Liver Cancer (BCLC) classification, and treatment allocation due to dual-tracer PET/CT. To characterize indeterminate lesions and unexplained elevation of serum AFP levels, the sensitivity and specificity of dual-tracer PET/CT in diagnosing HCC were evaluated. A multidisciplinary external review and a cost-benefit analysis of patients for metastatic screening were also performed. Results: Dual-tracer PET/CT identified new lesions in 14.3% of 273 staging patients, resulting in BCLC upstaging in 11.7% and treatment modifications in 7.7%. It upstaged 8.1% of 260 patients undergoing metastatic screening, with estimated savings of US$495 per patient. It had a sensitivity and specificity of 80.7% (95% CI 71.2-88.6%) and 94.8% (95% CI 90.4-98.6%), respectively, for diagnosing HCC in 201 indeterminate lesions. It detected HCC in 45.1% of 51 patients with unexplained elevations in serum AFP concentrations. External review revealed substantial agreement between local and external image interpretation and patient assessment (n = 273, κ = 0.822; 95% CI 0.803-0.864). Conclusions: Dual-tracer PET/CT provides added value beyond conventional imaging in patients with HCC by improving staging, confirming HCC diagnosis with high accuracy in patients with indeterminate lesions, and detecting HCC in patients with unexplained elevation of serum AFP. Impact and implications: Compared to CT or MRI, dual-tracer positron-emission tomography/computed tomography (PET/CT) led to upstaging in 12% of patients with hepatocellular carcinoma (HCC) undergoing staging, resulting in treatment modification in 8% of cases and a cost saving of US$495 per patient. It also accurately detected HCC in high-risk cases where CT or MRI were equivocal or normal. Dual-tracer PET/CT provides added value beyond conventional imaging in patients with HCC by improving staging, confirming HCC diagnosis with high accuracy in patients with indeterminate lesions, and detecting HCC in patients with unexplained elevation of serum AFP.
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