Department of Radiology of Kobe University School of Medicine, Kobe, Japan.
Eur J Radiol. 2013 Oct;82(10):1696-701. doi: 10.1016/j.ejrad.2013.05.019. Epub 2013 Jun 12.
To ascertain the role of respiratory-gated PET/CT with (18)F-fluorodeoxyglucose ((18)F-FDG) for accurate diagnosis of liver metastasis.
Forty patients with suspected liver metastasis underwent conventional whole-body PET/CT scan initially, followed by respiratory-gated PET/CT scan covering the liver. Visual detectability (using a 5-point confidence scale), maximum standardized uptake value (SUVmax) and metabolic tumor volume (MTV) of hepatic metastatic lesions were assessed for three data sets including ordinary whole-body (WB) scan, and non-respiratory-gated (nRG) and respiratory-gated (RG) scans. Results of enhanced CT and/or MRI, or clinical and radiological follow-up were used for reference.
Sixteen of the patients were found to have 53 metastatic lesions in the liver. Patient-based accuracy of WB, nRG, and RG was 92.5%, 95.0%, and 97.5%, respectively, with a lesion-based detection rate of 67.9%, 73.6%, and 73.6%, respectively. The average SUVmax of 34 liver metastatic lesions for WB, nRG, and RG was 6.60 ± 2.34, 7.19 ± 2.66, and 8.08 ± 3.24, respectively. SUVmax for RG was significantly higher than that for WB (p=0.0069). The average MTV of these 40 lesions for the three protocols was 5.32 ± 4.78 cm(3), 5.07 ± 4.73 cm(3), and 4.73 ± 4.67 cm(3), respectively. Among the three protocols, RG showed the best visual and quantitative evaluation for diagnosis of liver metastasis.
Respiratory-gated PET/CT allows more accurate identification of liver metastases than non-respiratory-gated PET/CT.
确定正电子发射断层扫描（PET）/计算机断层扫描（CT）联合（18）氟-脱氧葡萄糖（18F-FDG）呼吸门控技术在准确诊断肝转移中的作用。
40 例疑似肝转移患者首先行常规全身 PET/CT 扫描，然后行覆盖肝脏的呼吸门控 PET/CT 扫描。使用 5 分制置信度评分评估普通全身扫描（WB）、非呼吸门控（nRG）和呼吸门控（RG）扫描三组数据中肝转移瘤的视觉可检测性、最大标准化摄取值（SUVmax）和代谢肿瘤体积（MTV）。增强 CT 和/或 MRI 结果以及临床和影像学随访结果被用作参考。
16 例患者的肝脏共发现 53 个转移病灶。以患者为基础，WB、nRG 和 RG 的准确率分别为 92.5%、95.0%和 97.5%，以病灶为基础的检出率分别为 67.9%、73.6%和 73.6%。WB、nRG 和 RG 组 34 个肝转移病灶的 SUVmax 平均值分别为 6.60±2.34、7.19±2.66 和 8.08±3.24。RG 组 SUVmax 显著高于 WB 组（p=0.0069）。三组方案中 40 个病灶的 MTV 平均值分别为 5.32±4.78cm3、5.07±4.73cm3 和 4.73±4.67cm3。在这三种方案中，RG 方案在诊断肝转移方面具有最佳的视觉和定量评估。
与非呼吸门控 PET/CT 相比，正电子发射断层扫描（PET）/计算机断层扫描（CT）联合（18）氟-脱氧葡萄糖（18F-FDG）呼吸门控技术可更准确地识别肝转移灶。
