FDG PET for discrimination between tumor extension and blood thrombus as a cause for portal vein thrombosis in hepatocellular carcinoma: important role in exclusion of transplant candidacy.
FDG PET for discrimination between tumor extension and blood thrombus as a cause for portal vein thrombosis in hepatocellular carcinoma: important role in exclusion of transplant candidacy.
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DOI：
10.1097/01.rlu.0000162606.83862.a7
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发表时间：
2005-06
影响因子：
10.6
通讯作者：
J. Kurtovic;H. Van der Wall;S. Riordan
中科院分区：
文献类型：
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作者：
J. Kurtovic;H. Van der Wall;S. Riordan
对于肝硬化合并肝细胞癌（HCC）的患者，肝移植（LT）是治愈HCC和肝硬化的唯一希望。最近的数据表明，肝内肿瘤负荷比以前认为的更大的HCC患者可以预期LT的长期生存率。然而，由于早期肿瘤复发，肿瘤扩展到门静脉仍然是LT的绝对禁忌症。虽然门静脉血栓形成（PVT）很容易检测到动态计算机断层扫描或多普勒超声，这些不区分肿瘤的扩展和血栓，这通常发生在肝硬化，作为原因。我们报告一位46岁的男性，患有B型肝炎病毒相关的肝硬化并发肝细胞癌和门静脉血栓。正电子发射断层扫描使用F-18 FDG显示门静脉血栓的原因是肿瘤的扩展，而不是血栓，因此禁忌LT。在肝细胞癌合并门静脉血栓的患者中，门静脉中的F-18 FDG摄取异常提示肿瘤血栓，并在排除LT候选人中起着重要作用。
In patients with cirrhosis and complicating hepatocellular carcinoma (HCC), liver transplantation (LT) offers the only hope for cure of both the HCC and cirrhosis. Recent data indicate that patients with HCC with larger intrahepatic tumor burdens than previously thought can expect excellent long-term survival with LT. However, tumor extension into the portal vein remains an absolute contraindication to LT because of early tumor recurrence. Although portal vein thrombosis (PVT) is readily detected by dynamic computed tomography or Doppler ultrasound, these do not discriminate between tumor extension and blood thrombus, which occurs commonly in cirrhosis, as the cause. We report a 46-year-old man with hepatitis B virus-related cirrhosis complicated by HCC and PVT. Positron emission tomography using F-18 FDG showed the cause of PVT to be tumor extension rather than blood thrombus, thereby contraindicating LT. In patients with HCC with PVT, abnormal F-18 FDG uptake in the portal vein indicates tumor thrombus and plays an important role in excluding LT candidacy.