The use of positron emission tomography in detecting hepatoblastoma recurrence—a cautionary tale

• Published in: Journal of pediatric surgery Vol. 39; no. 12; pp. 1779 - 1781
• Main Authors: Wong, Kenneth K.Y., Lan, Lawrence C.L., Lin, Steve C.L., Tam, Paul K.H.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.12.2004
• Subjects: Child, Preschool; Female; Hepatoblastoma; Hepatoblastoma - diagnostic imaging; Humans; Infant; Liver Neoplasms - diagnostic imaging; Male; Neoplasm Recurrence, Local - diagnostic imaging; Positron-Emission Tomography; Retrospective Studies; tumor recurrence; positron emission tomography; tumor recurrence; Hepatoblastoma
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2004.08.033

The use of positron emission tomography (PET) with [18F] fluorodeoxyglucose (FDG) in the detection of recurrences has been well established in many tumor types. Here the authors present their experience using this modality in the evaluation of posttreatment hepatoblastoma patients. The authors conducted a retrospective review on patients with hepatoblastoma diagnosed from 1996 to 2003. FDG-PET imaging was performed together with measurement of alpha-fetal protein (AFP) during posttreatment follow-up. Sixteen patients (8 boys and 8 girls) were identified in this series. The mean age was 23.5 months (range, 5 months to 4 years). Three posttreatment patients had PET results suggestive of tumor recurrence. One of these patients had normal AFP level and suspected recurrence in the caudate lobe. Radiologic-guided biopsy was performed 3 times, and there was no evidence of tumor. The other 2 patients underwent further liver resections because of mildly raised AFP levels. The histology of these showed regenerative liver tissue only with no hepatoblastoma recurrence. Although PET has been gaining popularity as a tool in the detection of tumor recurrences worldwide, it has been shown in this series that PET may not be useful in hepatoblastoma patients, and caution must be taken in the interpretation of positive results.