Role of dual-time point 18F-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma
Role of dual-time point 18F-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma
复制标题
DOI：
10.1007/s00261-021-03071-2
复制
发表时间：
2021-04-07
影响因子：
2.4
通讯作者：
Liu, Houbao
中科院分区：
文献类型：
--
作者：
Pang, Lifang;Bo, Xiaobo;Liu, Houbao
目的探讨双时间点F-18-FDG PET/CT显像在肝门部胆管癌（HCCA）诊断和分期中的作用。方法回顾性分析69例经病理证实的HCCA患者的FDGPET/CT双时间点表现，包括早期全身扫描和腹部延迟扫描，分别于放射性示踪剂注射后1 h和2 h进行。PET/CT检查的评价基于视觉判读和半定量指标SUVmax和肿瘤与正常肝组织的比率（TNR）的早期和延迟图像。结果69例HCCA患者中，延迟期病灶和TNR的平均SUVmax分别为6.1 ± 4.7，2.2 ± 1.7，5.1 ± 3.4，1.6 ± 1.1，均显著高于早期（P < 0.001）。早期诊断原发灶的敏感性和准确性分别为69.6%和70%，延迟期分别为76.8%和76.8%。两种双时相显像中病灶SUVmax与Ki 67指数均呈显著相关（早期r = 0.462，P < 0.001;延迟期r = 0.47，P < 0.001）。早期预测淋巴结转移的敏感性、特异性和准确性分别为50%、67.3%和71%，延迟期分别为62.5%、73.3%和76.8%。FDGPET/CT诊断远处转移的敏感性、特异性和准确性分别为75%、100%和97.1%。早期和延迟期对远处转移的预测无差异。结论F18-FDG PET/CT双时相延迟显像对HCCA原发灶和淋巴结转移灶的检出有重要价值，但对远处转移灶的检出无明显价值。早期和延迟相的SUVmax可用于评估治疗前HCCA的肿瘤侵袭性。
Purpose The aim of this study was to evaluate the role of dual-time point F-18-FDG PET/CT imaging in the primary diagnosis and staging of hilar cholangiocarcinoma (HCCA). Methods Dual-time point FDG PET/CT findings, including early phase whole-body scanning and abdominal delayed phased performed 1 and 2 h after radiotracer injection, respectively, were retrospective reviewed in 69 patients conformed HCCA by histology. PET/CT was evaluated based on visual interpretation and the semiquantitative index of SUVmax and tumor-to-normal liver tissue ratio (TNR) for both early and delayed images. Results For all 69 HCCA patients, the mean SUVmax of the lesion and TNR in delayed phase was significantly higher than that in early phase (6.1 +/- 4.7, 2.2 +/- 1.7, vs 5.1 +/- 3.4, 1.6 +/- 1.1; P < 0.001). The sensitivity and accuracy value of detection primary lesions was 69.6% and 70% in early phase vs 76.8% and 76.8% in delay phase, respectively. There was a significant correlation between lesion SUVmax and Ki67 index in both dual-time imaging (r = 0.462, P < 0.001 in early phase vs r = 0.47, P < 0.001 in delay phase). The sensitivity, specificity and accuracy value of metastatic lymph nodes prediction was 50%, 67.3% and 71% in early phase vs 62.5%, 73.3% and 76.8% in delayed phase, respectively. The sensitivity, specificity and accuracy of FDG PET/CT in detecting distant metastasis in our study was 75%, 100% and 97.1%. There was no difference of predicting distant metastasis between early phase and delayed phase. Conclusion Delayed phase in dual-time point F-18-FDG PET/CT scan provides additional usefulness for detection primary tumor and lymph nodes metastases in HCCA, but there was no added benefit of delayed PET/CT imaging in detection of distant metastases in this study. SUVmax in early and delayed phase could be used to assess tumor aggressiveness in pre-treatment HCCA.