Utility of positron emission tomography-computed tomography scan in detecting residual hepatocellular carcinoma post treatment: Series of case reports

Table 1 How positron emission tomography-computed tomography altered medical management in our cases

Case	Indication for PET-CT	How PET-CT changed management
Case 1	To rule out metastatic HCC while AFP in the 7000s; chest CT and bone scan had been negative	The PET-CT scans successfully detected residual HCC in the treated areas in both lobes and allowed for appropriate treatments to prolong his survival by at least 36 mo; multiple multi-phase MRI scans failed to do so. Subsequently PET-CT scan subsequently detected a new HCC lesion when MRI did not
Case 2	To evaluate treatment response in a biopsy-proven hepatocellular carcinoma mixed with poorly differentiated carcinoma, which had had atypical characteristics on multi-phase CTs (MRI was contraindicated due to his pacemaker)	The PET-CT scan successfully revealed residual carcinoma and allowed for further treatment in prolonging survival
Case 3	To rule out metastatic HCC disease to the lungs in which anatomy had been distorted due to prior Tb infection	The PET-CT scan successfully detected residual HCC while a multi-phase MRI failed to do so. The PET-CT scan subsequently detected a metastatic focus to the bone and averted liver transplant
Case 4	To aid in the investigation of rising AFP in a treated HCC patient when multi-phase MRI scans had been negative	The PET-CT scan identified a recurrent HCC focus in the periphery of a previously treated HCC tumor location

PET-CT: Positron emission tomography-computed tomography; AFP: Alpha fetoprotein; HCC: Hepatocellular carcinoma; MRI: Magnetic resonance imaging.