Role of PET/CT in Evaluation of Locally Managed Hepatocellular Carcinoma with Negative CT/MRI Findings

Abstract Background Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death worldwide (HCC). It is the most common primary liver cancer. Loco-regional management is important for patient survival. Post-therapeutic follow-up and early detection of recurrent HCC are crucial in the management plan. Aim of the Work To highlight the role of PET/CT in evaluation of post therapeutic hepatocellular carcinoma in comparison to traditional cross-sectional imaging (CT/MRI) Patients and Methods Type of Study: retrospective and prospective studies. Study Setting: The study was conducted in a private radiology center. Study Period: from March 2019 to March 2023. Study Population: This study enrolled 50 patients who had previously undergone local management, such as trans-arterial chemoembolization, radiofrequency ablation, a combination of these (trans-arterial chemoembolization and radiofrequency ablation), and surgical resection. Results In the current study, 18F FDG PET/CT showed 95.6% sensitivity, 75 % specificity, 97.8% positive predictive value, 60% negative predictive value, and 94% accuracy. Conclusion 18F-FDG PET/CT is a valuable imaging tool to investigate the patients who have rising serum AFP level after HCC loco-regional treatment. It can accurately detect intrahepatic tumor recurrence as well as extrahepatic spread of HCC and can differentiate between benign and malignant portal vein thrombosis.