Emerging role of 18F-fluorodeoxyglucose positron emission tomography for guiding management of hepatocellular carcinoma

Figure 1 An example of the method for measuring metabolic tumor volume based on intensity-volume histogram from reference[88] with permission. Maximal intensity projection (A) and transaxial image (C) of ¹⁸F-fluorodexoyglucose (FDG) positron emission tomography (PET) and contrast-enhanced computed tomography image (B) showed a single hepatocellular carcinoma (HCC) with moderately increased FDG uptake. Regions of interest of HCC (red) and normal liver tissue (blue) are manually drawn on transaxial PET images (D). Cumulative intensity-volume histogram plots for HCC (red) and normal liver tissue (blue) are calculated from regions of interest. Standardized uptake value of the 97.5^th percentile of the voxels of the normal liver tissue was 2.7 (blue box) and the fraction of the tumor volume with ≥ 2.7 was 71.9% (black box). As the total tumor volume was 27.9 cm³ (red box), sum of the tumor voxels over the standardized uptake value of the 97.5^th percentile of the normal liver tissue voxels of the patient was 20.1 cm³. HCC: Hepatocellular carcinoma; SUV: Standardized uptake value.