摘要
目的:探讨18F-FDGPET/CT在肝细胞癌治疗后AFP升高而常规检查不能明确诊断的患者中的临床应用价值。方法:回顾性分析肝细胞癌行外科切除、肝动脉化疗栓塞(TACE)或射频消融(RFA)术治疗后AFP升高而常规检查未发现异常的17例患者的18F-FDGPET/CT图像,并和组织学、影像学及临床随访对比,临床随访时间均大于6个月。结果:17例患者中12例确诊肝细胞癌复发,6例病灶位于肝内,3例病灶位于肝外,3例肝内外均发现病灶。肝外病灶为淋巴结转移3例,骨转移1例,双肺及左腹直肌转移1例,双肺及右膈肌脚转移1例。18F-FDGPET/CT诊断肝内复发7例,肝外转移6例。18F-FDGPET/CT诊断肝细胞癌治疗后复发真阳性10例,假阴性3例,真阴性4例,假阳性0例,其灵敏度、特异性、准确性、阳性预测值、阴性预测值分别为77%、100%、82%、100%、57%。结论:对肝细胞癌治疗后AFP升高而常规检查正常患者,18F-FDGPET/CT对发现其肝内复发及肝外转移有重要临床价值。
Objective： The aim of this study was to evaluate the value of 18F-FDG PET/CT in investigating hepatocellular carcinoma （HCC） with unexplained serum AFP elevation following surgical resection, trausarterial ehemoembolization （TACE） or radiofrequency ablation （RFA）. Methods： A retrospective study was eotldueted involving 17 HCC patients Who underwent 18F- FDG PET/CT to explain the evaluation of AFP without evidence of HCC recurrence examined by routine imaging. The 18F- FDG PET/CT results were correlated with histological findings, as well as long-term radiologieal and clinieal follow-up（shortest follow-up period after FDG-PET was 6 months）. Results： Among 17 patients, 12 patients demonstrated HCC recurrence （6 intrahepatic, 3 extrahepatic and 3 intrahepatie/extrahepatic）. Metastatic loci were found in lymph node （3 patients）, bone （1 patient）, lung and muscle（1 patient）, lung and erura of diaphragm （1 patient）. The 18F-FI）G PET/CT identified 7 intrahepatie and 6 extrahepatie. Overall, ISF-FDG PET/CT had 10 true-positives, 3 false-negatives, 4 true-negatives and no false-positives for the detection of HCC recurrence. The sensitivity, specificity, positive predictive value and negative predictive value were 77%, 100%, 82%, 100%,, 57%, respectively. Conclusions： When conventional examinations are normal, the 18F-FDG PET/CT exami- nation is a valuable imaging tool in patients who have elevated AFP value after HCC treatment.
出处
《中国临床医学影像杂志》
CAS
北大核心
2010年第9期629-631,共3页
Journal of China Clinic Medical Imaging
