Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, 21201, USA.
Ann Nucl Med. 2013 Jan;27(1):58-64. doi: 10.1007/s12149-012-0656-6. Epub 2012 Oct 11.
Treatment effect of radiofrequency ablation (RFA) is traditionally accomplished with MRI and/or CT. The aim of the study was to assess the role of FDG-PET in post RFA hepatic tumor evaluation, in comparison with MRI and CT.
28 patients (33 hepatic RFA lesions) who had post RFA FDG-PET within 8 weeks of abdominopelvic MRI or CT were retrospectively reviewed. Accuracy of FDG-PET on post hepatic RFA evaluation was compared with MRI and/or CT based on clinical and imaging follow-up.
Among total of 33 RFA-treated lesions, 17 had residual or recurrent tumor (positive). PET identified 16 with a sensitivity of 94.1 %. Of these 17 lesions, 12 had concurrent MRI and 8 were positive with a sensitivity of 66.7 %. Similarly, 6 out of the 17 lesions had CT and 4 were positive with a sensitivity of 66.7 %. Sixteen lesions were successfully ablated (negative). Among them FDG-PET was negative in 13 with a specificity of 81.3 %; MRI was performed in 8 and 7 were negative with a specificity of 87.5 %; CT was performed in 8 and 5 were negative with a specificity of 62.5 %. The overall accuracy of PET, MRI and CT was 87.9, 75.0, and 64.3 %, respectively. The average scan numbers for PET, MRI and CT to achieve a final accurate diagnosis were 1.121, 1.316 and 1.250, with a corresponding cost of $1455.2, $1845.8, and $933.8, respectively.
The study suggests that FDG-PET is superior to MRI and/or CT and is more cost-effective in post RFA hepatic tumor assessment.
射频消融（RFA）的治疗效果传统上是通过 MRI 和/或 CT 来实现的。本研究旨在评估 FDG-PET 在肝肿瘤 RFA 后评估中的作用，并与 MRI 和 CT 进行比较。
回顾性分析了 28 例（33 个肝 RFA 病变）在腹部 MRI 或 CT 后 8 周内行 FDG-PET 的患者。根据临床和影像学随访，比较了 FDG-PET 在肝 RFA 后评估中的准确性与 MRI 和/或 CT。
在总共 33 个 RFA 治疗的病变中，有 17 个有残留或复发性肿瘤（阳性）。PET 检测到 16 个，敏感性为 94.1%。这 17 个病灶中，12 个有同时的 MRI 且 8 个阳性，敏感性为 66.7%。同样，6 个病灶有 CT，4 个阳性，敏感性为 66.7%。16 个病灶成功消融（阴性）。其中 13 个 FDG-PET 阴性，特异性为 81.3%；MRI 进行了 8 次，7 次阴性，特异性为 87.5%；CT 进行了 8 次，5 次阴性，特异性为 62.5%。PET、MRI 和 CT 的总体准确性分别为 87.9%、75.0%和 64.3%。实现最终准确诊断的 PET、MRI 和 CT 的平均扫描次数分别为 1.121、1.316 和 1.250，相应的费用分别为 1455.2 美元、1845.8 美元和 933.8 美元。
本研究表明，FDG-PET 在肝肿瘤 RFA 后评估中优于 MRI 和/或 CT，且更具成本效益。
