Sugiyama Masahiro, Sakahara Harumi, Torizuka Tatsuo, Kanno Toshihiko, Nakamura Fumitoshi, Futatsubashi Masami, Nakamura Satoshi
Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, 431-3192, Hamamatsu, Japan.
J Gastroenterol. 2004 Oct;39(10):961-8. doi: 10.1007/s00535-004-1427-5.
Positron emission tomography (PET) with 18F-fluoro-2-deoxy-D-glucose (18F-FDG) is useful in detecting distant metastases from a variety of malignancies. However, its efficiency in detecting distant metastases from hepatocellular carcinoma (HCC) has not been investigated. The aim of this study was to evaluate the usefulness of 18F-FDG PET for the detection of extrahepatic metastases from HCC.
Nineteen patients suspected of having extrahepatic HCC underwent 18F-FDG PET. Fourteen patients (group A) had extrahepatic lesions, which were detected by conventional studies. In five patients (group B), conventional imaging showed no extra- or intrahepatic lesions, but the tumor marker levels were elevated. The PET results were compared with those obtained by histopathology or by clinical follow-up.
The detection rate of 18F-FDG PET was 83% (24 of 29 metastases) for extrahepatic metastases larger than 1 cm in greatest diameter and 13% (1 of 8 metastases) for lesions less than or equal to 1 cm. PET revealed two bone metastases not depicted by bone scan, and detected the nodal metastasis and intestinal metastases inconclusive on computed tomography. Extrahepatic lesions were resected in 5 patients of group A on the basis of PET findings. In all patients of group B, PET results were true negative for extrahepatic metastases, but HCCs were detected in the liver within 4 months in 4 patients. These were no false-positive lesions in either group.
This preliminary study suggested that 18F-FDG PET could provide additional information and contribute to the management of HCC patients suspected of having extrahepatic metastases.
正电子发射断层扫描（PET）结合18F-氟-2-脱氧-D-葡萄糖（18F-FDG）有助于检测多种恶性肿瘤的远处转移。然而，其在检测肝细胞癌（HCC）远处转移方面的效率尚未得到研究。本研究的目的是评估18F-FDG PET在检测HCC肝外转移中的作用。
19例疑似肝外HCC的患者接受了18F-FDG PET检查。14例患者（A组）有肝外病变，这些病变通过传统检查发现。5例患者（B组），传统影像学检查未发现肝内或肝外病变，但肿瘤标志物水平升高。将PET结果与组织病理学或临床随访结果进行比较。
对于最大直径大于1 cm的肝外转移灶，18F-FDG PET的检出率为83%（29个转移灶中的24个），对于直径小于或等于1 cm的病变，检出率为13%（8个转移灶中的1个）。PET发现了2例骨扫描未显示的骨转移，并检测到计算机断层扫描结果不明确的淋巴结转移和肠转移。A组5例患者根据PET结果切除了肝外病变。在B组所有患者中，PET结果对肝外转移为真阴性，但4例患者在4个月内肝脏中检测到HCC。两组均无假阳性病变。
这项初步研究表明，18F-FDG PET可以提供额外信息，并有助于对疑似有肝外转移的HCC患者进行管理。
