Impact of whole-body imaging on treatment decision to radio-frequency ablation in patients with malignant liver tumors: comparison of [18F]fluorodeoxyglucose-PET/computed tomography, PET and computed tomography

Nucl Med Commun. 2008 Jul;29(7):599-606. doi: 10.1097/MNM.0b013e3282f8144d.


Objective: The correct staging of patients with malignant liver tumors before radio-frequency ablation (RFA) is mandatory for successful treatment. Our study aimed to compare the influence on decision to perform RFA of whole-body fluorodeoxyglucose (FDG)-PET/computed tomography (CT) with whole-body contrast-enhanced CT (CE-CT) and PET alone.

Methods: Fifty-eight patients with known hepatic malignancies (23, liver metastases 35) received FDG-PET/CT before RFA planned with curative intention. CT and PET data were each read separately, PET/CT fusion data were read in consensus afterward by a third reader group. The diagnostic accuracy of CE-CT, PET alone, and PET/CT to identify patients eligible for RFA was compared and the impact on decision was analyzed. The McNemar test with Bonferroni correction was used to test for significant differences.

Results: The accuracy and sensitivity to detect correctly intrahepatic and extrahepatic tumor were 94 and 97% for CT, 75 and 54% for PET, and 97 and 95% for PET/CT. The differences between CT and PET, as well as between PET/CT and PET, were statistically significant, but there was no significant difference between PET/CT and CT alone (P>0.65). PET alone, CE-CT, and PET/CT correctly identified 32, 55, and 57 patients, respectively. Again, PET/CT showed no significant advantage over CE-CT. Both imaging methods performed significantly better than PET alone (P<0.0001). Forty-three (74%) of 58 patients underwent RFA with curative intention.

Conclusion: Whole-body imaging changed patient management in 26% of the patients planned for curative intended RFA, yet there was no significant difference between CE-CT and PET/CT.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation / methods*
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Patient Selection
  • Positron-Emission Tomography / methods*
  • Preoperative Care / methods*
  • Radiopharmaceuticals
  • Subtraction Technique
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18