Incremental diagnostic value of F-18 FDG PET/CT over MRI in a pediatric patient with suspected hepatoblastoma and histologic diagnosis of focal nodular hyperplasia

A comparison between ¹⁸F-FDG PET/CT imaging and biological and radiological findings in restaging of hepatoblastoma patients

BACKGROUND

In this study we retrospectively evaluated if ¹⁸F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging.

PROCEDURE

Nine patients (mean age: 5.9 years; range: 3.1-12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard.

RESULTS

α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but ¹⁸F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. ¹⁸F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results.

CONCLUSIONS

¹⁸F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients.