^(18)F-FDGPET显像监测肝癌TACE治疗疗效

Monitoring Liver Cancer after TACE by ~ (18)F-FDG PET

目的 :评价18F FDGPET显像监测肝癌动脉插管化疗加栓塞 (TACE)疗效的作用。材料和方法 :3 3例肝癌患者 ,男 2 6例 ,女 7例 ,年龄 2 5～ 74岁 ,18F FDGPET共检查 40人次。其中有 7人 2次行PET显像检查。结果 :2 1例原发性肝癌(HCC)TACE后 ,11例病灶部位代谢降低呈放射性稀疏或缺损 ,SUV1.2～ 1.5 ,其中有 8例SUVratio≤ 0 .6;9例肝脏原发灶代谢增高 ,SUV3 .0～ 7.3 ;1例HCC伴腹水患者PET检查阴性 ,但CT发现肝内结节伴门静脉癌栓形成。 2例胆管细胞癌中 ,1例阴性 ,另 1例第 2次PET检查发现肝门部、腹腔淋巴结转移。 3例转移性肝癌病灶呈放射性缺损 ,SUV1.1～ 1.3 ;其余 7例患者肝内呈多灶性高代谢区 ,SUV3 .0～ 7.6。结论 :FDGPET显像是判断肝癌TACE后肿瘤坏死与存活的有效方法。

Purpose: In order to monitor response to therapy of liver cancer after transcatheter arterial chemoembolization (TACE), the imaging features of ~ 18F-FDG PET were investigated. Materials and Methods: 33 patients (26 male, 7 female; 25～74 years) with primary liver cancer and liver metastases underwent PET with ~ 18F-FDG after TACE. Results: After TACE the FDG uptakes were decreased markedly in 11 of 21 cases with hepatocellular carcinoma (HCC) (SUV: 1.2～1.5; SUV ratio ≤0.6 in 8, > 0.6 in 3 cases). FDG uptakes were increased significantly in 9 recurrenct HCC (SUV: 3.0～7.3). False negative PET was encountered in one HCC with ascites, in whose liver two lesions (2.0×2.0cm, 3.0×3.0cm) in both lobes with cancer embolism in porta vein were found by CT. There were 7 patients with remote metastasis. One cholangiocarcinoma did not show abnormal uptake but another showed high uptake of FDG. In patients with liver metastases, FDG uptakes decreased significantly in 3 of 10 cases (SUV: 1.1～1.3; SUV ratio ≤0.6 in 2 of 3 cases) and were increased in 7 of 10 cases (SUV: 3.0～7.6). 4 cases of extrahepatic metastases, such as lymph-node and lung metastases, were found by PET. Conclusion: FDG PET appears to be a valuable method for the assessment of tumor viability after TACE for liver cancer.