Metabolic restaging of hepatocellular carcinoma using whole-body F-FDG PET/CT.
Metabolic restaging of hepatocellular carcinoma using whole-body F-FDG PET/CT.
复制标题
使用全身 F-FDG PET/CT 对肝细胞癌进行代谢再分期。
作者：
Long Sun;Y. Guan;Wei;Zuoming Luo;Jihong Wei;Long Zhao;Hua Wu
目的
评价(18)F-氟脱氧葡萄糖正电子发射和计算机断层扫描((18)F-FDG PET/CT)对肝细胞癌(HCC)治疗后重新分期的能力。
方法
我们回顾了 (18)F-FDG PET/CT 扫描对局部或区域治疗后 HCC 患者的诊断性能数据库。该数据库包含21名男性和4名女性（年龄范围27-81岁；平均年龄51.6岁）患者的（18）F-FDG PET/CT信息，这些患者接受了手术切除和/或介入治疗，然后进行了（18）F-FDG PET/CT扫描。所有患者在 (18)F-FDG PET/CT 扫描之前或之后两周均接受了肝脏增强 CT 扫描。通过组织学分析或临床和影像学随访证实肝内复发和/或肝外转移。 (18)F-FDG PET/CT 研究的准确性由组织病理学结果或临床和影像学随访决定。
结果
(18)25例患者中19例(76.0%)F-FDG PET/CT异常。在检测 HCC 复发时，(18)F-FDG PET/CT 得分为 17 例真阳性、5 例真阴性、2 例假阳性和 1 例假阴性。 (18)F-FDG PET/CT检测HCC复发的敏感性、特异性和准确性分别为89.5%、83.3%和88%。 (18)F-FDG PET/CT 通过解决治疗后甲胎蛋白不明原因升高的问题（14 名患者）、监测治疗反应并指导额外的区域治疗（12 名患者）、识别肝外转移（10 名患者）、识别门静脉中的肿瘤生长或血栓形成（6 名患者）或指导肝外转移的手术切除（2 名患者），对这些患者的治疗产生影响。
结论
我们的结果表明，全身(18)F-FDG PET/CT可能有助于早期评估残余、肝内复发或肝外转移病灶，并能够为HCC复发的治疗提供有价值的信息。
AIM
To evaluate the ability of (18)F-fluorodeoxyglucose positron emission and computed tomography ((18)F-FDG PET/CT) in restaging of hepatocellular carcinoma (HCC) after treatment.
METHODS
We reviewed a database of the diagnostic performance of (18)F-FDG PET/CT scan for patients with HCC following local or regional treatment. The database consisted of (18)F-FDG PET/CT information of 21 male and 4 female (age range, 27-81 years; mean age, 51.6 years) patients who had received surgical resection and/or interventional treatments and then underwent (18)F-FDG PET/CT scan. All patients had received enhanced CT scan of the liver two weeks before or after the (18)F-FDG PET/CT scan. Intrahepatic recurrence and/or extrahepatic metastases were confirmed by histological analysis or clinical and imaging follow-up. The accuracy of (18)F-FDG PET/CT study was determined by histopathological results or by clinical and imaging follow-up.
RESULTS
(18)F-FDG PET/CT was abnormal in 19 of the 25 (76.0%) patients. In detecting HCC recurrence, (18)F-FDG PET/CT scored 17 true positives, 5 true negatives, 2 false positives and 1 false negative. The sensitivity, specificity and accuracy of (18)F-FDG PET/CT in detecting HCC recurrence was 89.5%, 83.3% and 88%, respectively. (18)F-FDG PET/CT had an impact on management of these patients by settling the problem of an unexplained increase in alpha-fetoprotein after treatment (14 patients), by monitoring response to the treatment and guiding additional regional therapy (12 patients), by identifying extrahepatic metastases (10 patients), by identifying tumor growth or thrombosis in the portal vein (6 patients), or by guiding surgical resection of extrahepatic metastases (2 patients).
CONCLUSION
Our results suggest that whole body (18)F-FDG PET/CT may be useful in the early evaluation of residual, intrahepatic recurrent or extrahepatic metastatic lesions and able to provide valuable information for the management of HCC recurrence.
DOI：
10.1097/01.rvi.0000200052.02183.92
发表时间：
2006-03-01
影响因子：
2.9
作者：
Kamel, IR;Bluemke, DA;Geschwind, JFH
通讯作者：
Geschwind, JFH