^18F-FDG PET/CT诊断肝细胞癌TACE术后存活或复发病灶的价值

Value of 18F-FDG PET/CT in diagnosing residual or recurrent hepatocellular carcinoma after TACE

目的探讨18F-FDG PET/CT诊断经导管肝动脉化疗栓塞(transcatheter arterial chemoembolization,TACE)术后存活或复发肝细胞癌(residual or recurrent HCC,rHCC)的准确性。方法回顾性分析44例TACE治疗后的HCC患者,总结分析18F-FDG PET/CT诊断TACE术后rHCC病灶的价值,并采用ROC曲线分析肿瘤与肝脏最大标准化摄取值比(SUVratio)对鉴别诊断rHCC病灶的价值。结果 TACE术后rHCC的18F-FDG PET/CT诊断敏感度、特异度和准确度分别为90.24%(37/41)、90.48%(19/21)、90.32%(56/62)。SUVratio值=1.49时具有最高的诊断效能,此时敏感度和特异度分别为93.3%、96.4%,AUC值为0.992(95%CI:0.985~0.999)。结论 18F-FDG PET/CT可准确诊断TACE术后rHCC,SUVratio值可作为鉴别坏死、存活或复发病灶的定量参数。

Objective To investigate the value of 18F-FDG PET/CT in diagnosing residual or recurrenttumors after transcatheter arterial chemoembolization(TACE)in hepatocellular carcinoma(HCC)patients.Methods From Janurary 2016 to December 2018,forty-four patients who had undergone TACE firstly were included in thisstudy. Diagnostic accuracy of 18F-FDG PET/CT was investigated,as well as receiver operator characteristics(ROC)was peformed to assess the value of tumor-to-liver ratio of standard uptake value(SUVratio)in detecting residualor recurrent HCCs(r HCCs).Results The sensitivity,specificity and accuracy of 18F-FDG PET/CT in diagnosingr HCCs were 90.24%(37/41),90.48%(29/21),and 90.32%(56/62),respectively. When the cutoff value was 1.49,Ratio SUV had the best diagnostic value in detecting r HCCs with the sensitivity of 93.3%,specificity of 96.4%,and an AUC value of 0.992(95%CI,0.985 ~ 0.999).Conclusion 18F-FDG PET/CT has higher diagnosticvalue in detecting rHCCs after TACE,and SUVratio value can be used as an efficient index to differentiate rHCCs.