^(18)F-FDG PET显像在肝细胞癌介入治疗后残留病灶检出中的应用

^(18F)-FDG PET imaging for detecting residual lesions of HCC after TACE

目的 探讨1 8F 脱氧葡萄糖 (FDG)PET显像对肝细胞癌介入治疗后残留病灶的诊断价值。方法 经穿刺活组织检查或手术病理检查证实的肝细胞癌患者 35例 ,回顾性分析经导管动脉化疗栓塞术 (TACE)后 1 5～ 2个月1 8F FDGPET显像对肝内肿瘤残留病灶的检出结果 ,并与同期平扫和增强碘油CT对比 ,以动脉造影和临床随访 6个月以上及部分病理检查结果为标准。结果 35例患者共 5 2个病灶 ,经动脉造影和临床随访 6个月以上及部分病理检查结果证实 ,有肿瘤残留病灶 31个 ,1 8F FDGPET显像检出 2 8个 ,碘油CT检出 19个 ;无肿瘤残留病灶 2 1个 ,1 8F FDGPET显像检出 2 0个 ,碘油CT检出 2 0个。1 8F FDGPET显像诊断肝癌介入治疗后肿瘤残留病灶的灵敏度和准确性 (分别为 90 3%、92 3% )明显高于碘油CT(分别为 6 1 3%、75 0 % ) ,差异有显著性 (P <0 0 1)。结论 1 8F FDGPET显像对检出肝细胞癌介入治疗后肿瘤残余病灶有优势 ,特别对碘油CT难以检出的残留病灶有临床价值 ,可为确定临床治疗方案提供依据。

Objective To evaluate the value of 18F-fluorodeoxyglucose (FDG) PET imaging for detecting residual lesions of hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE). Methods Two well-differentiated, 33 moderately- or poorly-differentiated HCC patients proven by biopsy or surgical pathohistology were included in the study. A retrospective analysis of detecting residual lesions with PET and CT was performed 1.5～2 months after TACE. PET and CT findings were compared on the basis of arteriography, clinical follow-up and histologic examination. Results Fifty-two lesions were found in 35 patients. Thirty-one lesions with and 21 lesions without residual viable tumor tissue were confirmed by the arteriography, clinical follow-up and histologic examination. Twenty-eight lesions with and 20 without residual viable tumor tissue were found on PET with 90.3% sensitivity, 92.3% accuracy. Nineteen lesions with and 20 lesions without residual viable tumor tissue were found on CT, and its sensitivity and accuracy were 61.3% and 75.0%. The sensitivity and accuracy of PET and CT for evaluating the residual viable tumor tissue of HCC after TACE were significantly different (P<0.01). Conclusions 18F- FDG PET imaging is superior to CT for detecting residual lesion of HCC after TACE, especially in the residual viable tumor lesions that cannot be deteced by CT. PET could evaluate the efficacy of TACE performed on HCC accurately, and provide important informations for the clinical treatment planning.