Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
Hepatol Res. 2009 Feb;39(2):134-42. doi: 10.1111/j.1872-034X.2008.00416.x.
To compare the efficacy of positron emission tomography (PET) computed tomography (CT), multi-detector helical computed tomography (MDCT) and bone scintigraphy for the detection of extrahepatic metastases in patients with hepatocellular carcinoma (HCC).
Thirty-four patients diagnosed with metastatic HCC were enrolled in this study. The lesions included lung (n = 18), bone (n = 12) and lymph node (n = 16) metastases. For receiver operating characteristic (ROC) analysis, lesions were diagnosed as metastatic HCC by two experienced abdominal radiologists. Another three physicians independently reviewed both positive and negative images. Each physician read three sets of images of MDCT, PET-CT and bone scintigraphy for bone metastasis.
The mean sensitivity and specificity for diagnosis of lung metastasis were 85.2 and 88.9% for MDCT, and 59.2 and 92.6% for PET-CT, respectively. For lymph node metastasis, these values were 62.5 and 79.2% for MDCT, and 66.7 and 91.7% for PET-CT, respectively; and for bone metastasis 41.6 and 94.5% for MDCT, 83.3 and 86.1% for PET-CT, and 52.7 and 83.3% for bone scintigraphy, respectively. The mean Az values were 0.95 and 0.77 for MDCT and PET-CT in lung metastasis, respectively, 0.75 and 0.80 for MDCT and PET-CT for lymph node metastasis, respectively, and 0.59, 0.88 and 0.62 for MDCT, PET-CT and bone scintigraphy for bone metastasis, respectively.
PET-CT has high sensitivity and is more suitable for the detection of bone metastases from primary HCC, relative to MDCT and bone scintigraphy.
比较正电子发射断层扫描（PET）计算机断层扫描（CT）、多层螺旋 CT（MDCT）和骨扫描对肝细胞癌（HCC）患者肝外转移的检测效果。
本研究纳入了 34 例经诊断患有转移性 HCC 的患者。病变包括肺（n = 18）、骨（n = 12）和淋巴结（n = 16）转移。为了进行受试者工作特征（ROC）分析，两位经验丰富的腹部放射科医生将病变诊断为转移性 HCC。另外三位医生分别独立地对阳性和阴性图像进行了评估。每位医生阅读了 MDCT、PET-CT 和骨扫描三种方法用于骨转移的三组图像。
MDCT 诊断肺转移的平均敏感度和特异度分别为 85.2%和 88.9%，PET-CT 分别为 59.2%和 92.6%。对于淋巴结转移，MDCT 的值分别为 62.5%和 79.2%，PET-CT 分别为 66.7%和 91.7%；对于骨转移，MDCT 的值分别为 41.6%和 94.5%，PET-CT 的值分别为 83.3%和 86.1%，骨扫描的分别为 52.7%和 83.3%。MDCT 和 PET-CT 在肺转移中的平均 Az 值分别为 0.95 和 0.77，MDCT 和 PET-CT 在淋巴结转移中的分别为 0.75 和 0.80，MDCT、PET-CT 和骨扫描在骨转移中的分别为 0.59、0.88 和 0.62。
与 MDCT 和骨扫描相比，PET-CT 具有更高的敏感度，更适合检测原发性 HCC 的骨转移。
