In vivo confirmation of altered hepatic glucose metabolism in patients with liver fibrosis/cirrhosis by 18F-FDG PET/CT

ObjectiveThe aim of this study was to assess the value of F-18-FDG PET/CT for quantitative assessment of hepatic metabolism in patients with different stages of liver fibrosis/cirrhosis.Materials and methods(18)F-FDG PET/CT scans of 37 patients either with or without liver fibrosis/cirrhosis, classified according to the METAVIR score (F0-F4) obtained from histopathological analysis of liver specimen, were analyzed retrospectively and classified as follows: no liver fibrosis (F0, n=6), mild liver fibrosis (F1, n=11), advanced liver fibrosis (F2, n=6), severe liver fibrosis (F3, n=5), and liver cirrhosis (F4, n=11). The liver-to-blood ratio (LBR, scan time corrected for a reference time of 75min) was compared between patient groups.ResultsPatients with liver fibrosis or cirrhosis (F1; LBR 1.530.35) showed a significant higher LBR than patients with normal liver parenchyma (F0, 1.08 +/- 0.23; P=0.004). In direct comparison, LBR increased up to the advanced stage of liver fibrosis (F2; 2.00 +/- 0.40) and decreased until liver cirrhosis is reached (F4, 1.32 +/- 0.14).Conclusion Functional changes in liver parenchyma during liver fibrosis/cirrhosis affect hepatic glucose metabolism and significantly differ between stages of liver fibrosis/cirrhosis, classified according to the METAVIR scoring system, as demonstrated by LBR quantification by F-18-FDG PET/CT.