Anti-alpha-fetoprotein imaging is useful for staging hepatoblastoma
Kairemo, K.J.A.; Lindahl, H.; Merenmies, J.; Föhr, A.; Nikkinen, P.; Karonen, S-Liisa.; Makipernaa, A.; Höckerstedt, K.; Goldenberg, D.M.; Heikinheimo, M.
Transplantation 73(7): 1151-1154
2002
ISSN/ISBN: 0041-1337 PMID: 11965049 Document Number: 541557
Background: Liver transplantation (Tx) has become an alternative treatment of malignant childhood liver tumors, and the importance of careful pretransplantation evaluation has been emphasized. Anti-alpha-fetoprotein (AFP) imaging has been suggested for evaluation of adult patients with AFP-positive tumors. Methods: Antibody imaging utilizing Tc-99 m-labeled monoclonal anti-AFP Fab' fragments was used to demonstrate pathologic uptake in hepatoblastoma (HB). Results: Radical operation or liver Tx was not possible after four cycles of chemotherapy in a child with HB because of a single extrahepatic metastasis. Chemotherapy was continued, and reevaluation with anti-AFP imaging demonstrated a pathologic uptake only in the liver. Subsequently, a right liver lobe resection was performed. Along with a new rise in serum AFP, repeated anti-AFP imaging revealed active liver tumor but no metastases. A liver Tx was performed, and the child is well with a normal serum AFP level 18 months after the operation. Conclusion: This is the first case of pediatric HB in which anti-AFP imaging has been successfully used for patient management.