^(18)F-脱氧葡萄糖结合PET-CT显像诊断肝恶性肿瘤

Clinical evaluation of ^(18)F-FDE PET-CT in detecting malignant liver tumors

目的探讨18F-脱氧葡萄糖(18F-FDG)结合CT扫描融合显像(PET-CT)对肝恶性肿瘤诊断与分期的价值。方法对24例肝癌患者(原发性肝癌16例、肝转移癌8例)进行术前18F-FDG PET-CT显像。分析原发病灶的影像学特点,测定其标准摄取值;观察转移病灶18F-FDG的异常代谢情况,然后通过CT图像进行准确定位。结果16例原发性肝癌患者中,6例患者PET-CT阳性(占37.5%)。8例肝转移癌患者PET均示阳性。16例原发性肝癌中5例发现转移,找到转移结节14个。其中,肺部转移2例、腹腔转移3例。结论18F-FDG结合PET-CT显像对原发性肝癌的检出率仅为37.5%,在诊断原发性肝癌的使用中应当慎重,而对肝转移癌则敏感性较高,可作为一种较好的检查手段,尤其对原发性肝癌的分期有很高的诊断价值。

Objective To evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) positron-emission tomography (PET) combined with computer tomography (PET-CT) in the diagnosis and clinical staging of liver cancer. Methods 18F-FDG PET-CT was performed preoperatively in 16 cases of primary and 8 metastatic liver cancers. The imaging features of the primary foci were analyzed, followed by measurement of standardized 18F-FDG uptake. For the metastatic foci, the abnormal metabolism of 18F-FDG was observed and CT, PET and PET-CT fusion images were obtained for accurate localization of these foci. Results 18F-FDG uptake occurred in the supraclavicular region in 6 (37.5%) of the 16 patients with primary liver cancer, but was detected in the 8 patients with metastatic liver cancer. Fourteen metastatic nodules were found in 5 of the 16 patients with primary liver cancer, located in the lungs (2 cases) or the abdominal cavity (3 cases). Conclusions Negative results of 18F-FDG PET-CT imaging should be carefuley evaluated for diagnosing primary liver cancers, considering the very low sensitivity (37.5%) of this imaging modality in this study. But in the cases of metastatic liver cancers this imaging modality may exhibit high sensitivity, and can also be of great value in clinical staging of the primary liver cancers.