PET/CT-guided Radiofrequency and Cryoablation: Is Tumor Fluorine-18 Fluorodeoxyglucose Activity Dissipated by Thermal Ablation?
PET/CT-guided Radiofrequency and Cryoablation: Is Tumor Fluorine-18 Fluorodeoxyglucose Activity Dissipated by Thermal Ablation?
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DOI：
10.1016/j.jvir.2010.11.027
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发表时间：
2011-03-01
影响因子：
2.9
通讯作者：
Silverman, Stuart G.
中科院分区：
文献类型：
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作者：
Sainani, Nisha I.;Shyn, Paul B.;Silverman, Stuart G.
目的：为了确定是否肿瘤氟-18氟脱氧葡萄糖在由正电子发射断层扫描/计算机断层扫描（PET/CT）引导的肿瘤消融期间，通过射频（RF）消融或冷冻消融来消散（F-18-FDG）活性。这项前瞻性研究招募了12名患者（9名女性和3名男性，39-65岁），每名患者至少有一个F-18-FDG-亲合性肝脏、肝周或肺肿瘤。6例患者（实验组）接受了经皮PET/CT引导下射频消融（n = 3）或冷冻消融（n = 3）。6例患者（对照组）接受诊断性PET/CT引导下经皮穿刺活检。在单次静脉F-18-FDG给药后平均103.5分钟，在所有患者中获得术前和术后PET/CT扫描，平均时间间隔为83.4分钟。测量靶区肿瘤最大标准化摄取值（TSUVmax）及TSUVmax与正常肝脏平均标准化摄取值（LSUVavg）的比值（SUVRatio）。比较两组术前和术后TSUVmax和SUVratio的百分比变化，并使用Student t检验进行分析（P <0.05，认为具有统计学意义）。结果：两组中所有患者的TSUVmax和SUVratio从术前到术后PET/CT扫描均增加，但无统计学显著差异。消融组的TSUVmax平均增加百分比为32.5%（范围8.2%-46.7%），活检组为24.6%（3.7%-42.4%; P = 0.45）。消融组SUVratio的平均百分比增加为47.9%（18.8%-69.6%），活检组为37.6%（9.4%-65%; P = 0.37）。结论：经皮射频消融或冷冻消融不会消除肿瘤F-18-FDG活性。当进行F-18-FDG PET/CT引导的射频消融或冷冻消融时，靶肿瘤F-18-FDG活性的变化不能用于监测治疗效果。
Purpose: To determine if tumor Fluorine-18 fluorodeoxyglucose (F-18-FDG) activity is dissipated by radiofrequency (RF) ablation or cryoablation during tumor ablation guided by positron emission tomography/computed tomography (PET/CT).Materials and Methods: This prospective study enrolled 12 patients (9 women and 3 men, 39-65 years old), each with at least one F-18-FDG-avid liver, perihepatic, or lung tumor. Six patients (experimental group) underwent percutaneous PET/CT-guided RF ablation (n = 3) or cryoablation (n = 3). Six patients (control group) underwent diagnostic PET/CT-guided percutaneous biopsy. At a Mean time of 103.5 minutes after a single intravenous F-18-FDG dose, preprocedure and postprocedure PET/CT scans, separated by a mean time interval of 83.4 minutes, were obtained in all patients. Target tumor maximum standardized uptake value (TSUVmax) and ratio (SUVratio) of TSUVmax to normal liver average standardized uptake value (LSUVavg) were measured on all scans. Percentage changes in TSUVmax and SUVratio from preprocedure to postprocedure scans were compared for both groups and analyzed using the Student t test (P < .05 considered statistically significant).Results: For all patients in both groups, TSUVmax and SUVratio increased from preprocedure to postprocedure PET/CT scans without statistically significant differences. The mean percentage increase in TSUVmax for the ablation group was 32.5% (range 8.2%-46.7%) and for the biopsy group was 24.6% (3.7%-42.4%; P = .45). The mean percentage increase in SUVratio for the ablation group was 47.9% (18.8%-69.6%) and for the biopsy group was 37.6% (9.4%-65%; P = .37).Conclusions: Tumor F-18-FDG activity is not dissipated by percutaneous RF ablation or cryoablation. When performing F-18-FDG PET/CT-guided RF ablation or cryoablation, changes in target tumor F-18-FDG activity cannot be used to monitor treatment effects.