{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T23:00:32Z","timestamp":1790290832191,"version":"4.1.0"},"reference-count":15,"publisher":"Georg Thieme Verlag KG","issue":"03","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Nucl Med"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This retrospective study aimed to assess whether choline PET\/CT provides additional independent prognostic value compared with magnetic resonance imaging (MRI) and [18F]FDG PET\/CT in treatment-na\u00efve patients with hepatocellular carcinoma (HCC). A total of 78 treatment-na\u00efve patients with predominantly single-lesion and early-stage HCC who underwent MRI, [18F]FDG PET\/CT, and choline PET\/CT were retrospectively included.<\/jats:p>\n                  <jats:p>Higher than median MRI-, choline and [18F]FDG PET\/CT-derived tumor volumes were associated with poorer overall survival (OS) in univariate analyses. An MRI-derived tumor volume\u2009&gt;\u200917.81\u2009mL was associated with worse OS (p\u2009=\u20090.005; hazard ratio [HR], 3.15; 95% confidence interval [CI], 1.41\u20137.03), as were choline PET\/CT tumor volume\u2009&gt;\u20098.4\u2009mL (p\u2009=\u20090.04; HR, 2.27; 95% CI, 1.03\u20135.01) and [18F]FDG positivity (p\u2009=\u20090.02; HR, 2.74; 95% CI, 1.11\u20136.81). After multivariate analysis with correction for multiple testing, only MRI-derived tumor volume remained an independent predictor of OS. Although associated with OS in univariate analyses, choline PET-derived metrics did not retain statistical significance after adjustment, suggesting limited incremental prognostic information beyond MRI-derived tumor burden. Liver transplantation and hepatectomy were associated with superior survival compared with locoregional therapies (p\u2009=\u20090.006). No significant correlations were observed between imaging parameters and \u03b1-fetoprotein (AFP) levels or ALBI score (all p\u2009&gt;\u20090.05). Interaction analyses did not detect any significant modification of the prognostic effect of choline PET imaging biomarkers by AFP levels, ALBI score, or Child\u2013Pugh class. Treatment modality emerged as the strongest prognostic factor in the penalized model using least absolute shrinkage and selection operator regularization, while choline PET-derived parameters did not show independent prognostic value.<\/jats:p>\n                  <jats:p>Choline PET\/CT did not demonstrate additional independent prognostic value beyond MRI or [18F]FDG PET\/CT in this cohort of treatment-na\u00efve patients with predominantly early-stage and single-lesion HCC.<\/jats:p>","DOI":"10.1055\/s-0046-1824460","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T23:23:11Z","timestamp":1781133791000},"page":"208-218","source":"Crossref","is-referenced-by-count":0,"title":["Limited Added Prognostic Value of Choline PET\/CT in Treatment-Na\u00efve Hepatocellular Carcinoma"],"prefix":"10.1055","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0640-0916","authenticated-orcid":false,"given":"Irina","family":"Vierasu","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugo","family":"Levillain","sequence":"additional","affiliation":[{"name":"Medical Physics Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Pezzullo","sequence":"additional","affiliation":[{"name":"Department of Radiology, H\u00f4pital Erasme, H\u00f4pital Universitaire de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Dhont","sequence":"additional","affiliation":[{"name":"Medical Physics Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hugues","family":"Azema","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8536-1259","authenticated-orcid":false,"given":"Hugo","family":"Couvert","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cl\u00e9mentine","family":"Marin","sequence":"additional","affiliation":[{"name":"Medical Physics Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0871-1822","authenticated-orcid":false,"given":"Nicola","family":"Trotta","sequence":"additional","affiliation":[{"name":"Medical Physics Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon","family":"Lacroix","sequence":"additional","affiliation":[{"name":"Nuclear Medicine Department, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana-Maria","family":"Bucalau","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gontran","family":"Verset","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Demols","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne","family":"Paesmans","sequence":"additional","affiliation":[{"name":"Information Management Unit, H\u00f4pital Universitaire de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Desislava","family":"Germanova","sequence":"additional","affiliation":[{"name":"Liver Transplant Unit, Department of Abdominal Surgery, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Lucidi","sequence":"additional","affiliation":[{"name":"Liver Transplant Unit, Department of Abdominal Surgery, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Tr\u00e9po","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatopancreatology and Digestive Oncology, H\u00f4pital Universitaire de Bruxelles, Universit\u00e9 Libre de Bruxelles, Brussels, 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