Nuclear imaging for functional evaluation and theragnosis in liver malignancy and transplantation

Abstract

Currently, nuclear imaging such as positron emission tomography (PET) and single photon emission computed tomography (SPECT) is increasingly used in the management of liver malignancy. ¹⁸F-fluorodeoxyglucose (FDG)-PET is the most widely used nuclear imaging in liver malignancy as in other cancers, and has been reported to be effective in diagnosis, response monitoring, recurrence evaluation, and prognosis prediction. Other PET imaging such as ¹¹C-acetate PET is also used complementarily to FDG-PET in diagnosis of liver malignancy. Additionally, image-based evaluation of regional hepatic function can be performed using nuclear imaging. Those imaging modalities are also effective for candidate selection, treatment planning, and perioperative evaluation in liver surgery and transplantation. Recently, nuclear imaging has been actively adopted in the transarterial radioembolization therapy of liver malignancy, according to the concept of theragnosis. With the development of new hybrid imaging technologies such as PET/magnetic resonance imaging and SPECT/CT, nuclear imaging is expected to be more useful in the management of liver malignancy, particularly regarding liver surgery and transplantation. In this review, the efficacy and roles of nuclear imaging methods in diagnosis, transplantation and theragnosis are discussed.

Keywords: Nuclear imaging, Liver malignancy, Transplantation, Positron emission tomography-computed tomography, Theragnosis

Core tip: Nuclear imaging methods including single photon emission computed tomography (SPECT) and positron emission tomography (PET) are increasingly being used in the management of liver malignancy. In this review, the efficacy and clinical role of nuclear imaging methods are discussed with regard to fluorodeoxyglucose PET and other PET or SPECT imaging methods. In particular, the application of nuclear imaging for theragnosis and surgical intervention including transplantation is discussed in detail. This review may be helpful for understanding current trends of nuclear imaging for liver malignancy.