Kuehl Hilmar, Antoch Gerald, Stergar Hrvoje, Veit-Haibach Patrick, Rosenbaum-Krumme Sandra, Vogt Florian, Frilling Andrea, Barkhausen Joerg, Bockisch Andreas
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D 45122 Essen, Germany.
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Hufelandstr. 55, D 45122 Essen, Germany.
Eur J Radiol. 2008 Aug;67(2):362-371. doi: 10.1016/j.ejrad.2007.11.017. Epub 2007 Dec 26.
Morphologic imaging after radiofrequency ablation (RFA) of liver metastases is hampered by rim-like enhancement in the ablation margin, making the identification of local tumor progression (LTP) difficult. Follow-up with PET/CT is compared to follow-up with PET alone and MRI after RFA.
Sixteen patients showed 25 FDG-positive colorectal liver metastases in pre-interventional PET/CT. Post-interventional PET/CT was performed 24h after ablation and was repeated after 1, 3 and 6 months and then every 6 months. PET and PET/CT data were compared with MR data sets acquired within 14 days before or after these time points. Either histological proof by biopsy or resection, or a combination of contrast-enhanced CT at fixed time points and clinical data served as a reference.
The 25 metastases showed a mean size of 20mm and were treated with 39 RFA sessions. Ten lesions which developed LTP received a second round of RFA; four lesions received three rounds of treatment. The mean follow-up time was 22 months. Seventy-two PET/CT and 57 MR examinations were performed for follow-up. The accuracy and sensitivity for tumor detection was 86% and 76% for PET alone, 91% and 83% for PET/CT and 92% and 75% for MRI, respectively.
In comparison to PET alone, PET/CT was significantly better for detecting LTP after RFA. There were no significant differences between MRI and PET/CT. These preliminary results, however, need further verification.
肝转移瘤射频消融（RFA）后的形态学成像受到消融边缘环状强化的影响，难以识别局部肿瘤进展（LTP）。比较RFA后PET/CT随访与单独PET随访及MRI随访的情况。
16例患者在介入前PET/CT检查中显示25个FDG阳性结直肠癌肝转移瘤。消融后24小时进行介入后PET/CT检查，并在1、3和6个月后重复检查，之后每6个月检查一次。将PET和PET/CT数据与在这些时间点前后14天内获取的MR数据集进行比较。通过活检或切除获得的组织学证据，或固定时间点的增强CT与临床数据相结合作为参考。
25个转移瘤平均大小为20mm，接受了39次RFA治疗。10个发生LTP的病灶接受了第二轮RFA治疗；4个病灶接受了三轮治疗。平均随访时间为22个月。为进行随访共进行了72次PET/CT检查和57次MR检查。单独PET检测肿瘤的准确性和敏感性分别为86%和76%，PET/CT为91%和83%，MRI为92%和75%。
与单独PET相比，PET/CT在检测RFA后LTP方面明显更好。MRI和PET/CT之间无显著差异。然而，这些初步结果需要进一步验证。
