Baseline fluorodeoxyglucose PET/computed tomography volumetric parameters predict response to transarterial...

To evaluate the prognostic value of baseline 18 F-fluorodeoxyglucose (FDG) PET/computed tomography (CT)-derived metabolic parameters and lung shunt fraction (LSF) in predicting treatment response following transarterial radioembolization (TARE) in patients with primary and metastatic liver tumors.

This prospective study included patients with primary or metastatic liver tumors who underwent TARE and baseline 18 F-FDG PET/CT imaging. Metabolic parameters, including maximum standardized uptake value (SUV max ), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and tumor-to-liver ratio (TLR), were calculated. Treatment response was assessed using posttreatment imaging. Overall survival (OS) and progression-free survival (PFS) were analyzed using the Kaplan-Meier method, with Cox regression and receiver operating characteristic (ROC) analyses performed.

MTV and TLG were significantly higher in nonresponders than in responders ( P < 0.05), whereas SUV max and TLR were not associated with response. Subgroup analysis showed that MTV and TLG retained predictive value in primary liver tumors but not in metastatic tumors. ROC analysis demonstrated moderate predictive performance. Responders had significantly longer OS ( P = 0.05), while PFS did not differ. LSF was not associated with treatment response or survival.

Baseline volumetric metabolic parameters, particularly MTV and TLG, are associated with treatment response following TARE, with stronger predictive value in primary liver tumors. These findings suggest a potential role for volumetric tumor burden in treatment stratification.