Diagnostic Accuracy of Fluoro-2-Deoxy-D-Glucose Positron Emission Tomography with Computer Tomography in Detection of Hepatocellular Carcinoma and Its Extrahepatic Metastases

Introduction: Hepatocellular carcinoma (HCC) is a global health concern, ranking seventh in cancer incidence and third in cancer-related mortality. Extrahepatic metastases occur in 37% of cases, with common sites being the lung, lymph nodes, and bone. While contrast-enhanced triphasic computed tomography and magnetic resonance imaging are standard for HCC staging, they have limitations in detecting metastases. PET/CT, combining PET's metabolic imaging with CT's anatomical detail, offers a comprehensive approach without patient movement facilitating accurate lesion localization. This study aimed for assessment of efficacy of PET/CT in the detection of hepatocellular carcinoma and its extrahepatic metastases. Patients and Methods: Our study involved 18 pathologically proven HCC patients collected between October 2022 and November 2023. Cases underwent various interventions.Post-procedure CT follow-up was performed on all patients, and PET/CT was conducted in clinically suspected extrahepatic metastases cases. Written informed consent was obtained, and the study protocol received institutional ethics approval. Results: PET/CT has 100% sensitivity and 33.3% specificity for HCC focal lesions. It ranges from 50% to 100% sensitivity and specificity for various metastases such as lymph nodes, vertebral, and pulmonary. For instance, lymph nodes show 87.5% sensitivity and 100% specificity, vertebral metastases exhibit 66.67% sensitivity and 93.33% specificity, while pulmonary metastases display 50% sensitivity and 100% specificity. Conclusion: Our study demonstrates role of PET/CT in HCC management, enabling early detection of metastases and guiding treatment. Despite variations in diagnostic accuracy, PET/CT remains important for assessing disease spread and recurrence.