الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Hepatocellular carcinoma (HCC) is the most frequent primary liver cancer. Loco-regional management is important for patient survival. Post-therapeutic follow-up and early detection of recurrent HCC is crucial in management plan (66 ,69).
The aim of the study is to highlight the role of the 18F-FDG PET/CT as a valuable imaging tool in evaluating patients who have rising AFP levels after HCC local management and also very important for earlier detection of post-treatment tumor recurrence and extrahepatic metastases than other conventional imaging modalities.
This study enrolled 50 patients (42 males and 8 females). All patients had undergone loco-regional treatment including TACE (19 patients), RFA (18 patients), combination of these (TACE + RFA) in 7 patients and surgical resection in 6 patients.
Forty-six patients had persistent elevated AFP levels and the remaining four patients had normal levels of AFP and were prepared for liver transplantation.
The forty-six patients with persistent elevated AFP levels show positive findings on PET/CT except a single case showed a false negative result in spite of elevated AFP as they are well-differentiated HCC type.
Among the forty-six patients with elevated AFP levels, seventeen patients were positive for viable tumoral tissue at site of local management, eight patients show extra hepatic metastatic spread in spite of successful local management, twenty patients shows both viable tumoral tissue at site of local management and extra hepatic metastatic spread.
Four patients with normal AFP level showed negative findings on PET/CT, except one patient on PET/CT showed false positive due to regional hyperemia causing increased FDG uptake.
This study demonstrates the efficacy of (PET/CT) in follow-up of locally managed hepatocellular carcinoma (HCC) patients as it evaluates viability based on glycolytic activity and not influenced by tumor size, morphology or lipidol deposition.
The current study reveals high diagnostic performance of 18F FDG PET/CT over other conventional imaging modalities (CT -MRI), It shows 97.8 % sensitivity, 75 % specificity, 97.8% positive predictive value, 75 % negative predictive value, and 96 % accuracy.