Ferda Jiří, Ferdová Eva, Baxa Jan, Kreuzberg Boris, Daum Ondřej, Třeška Vladislav, Skalický Tomáš
Department of Imaging Methods, Charles University Teaching Hospital Pilsen, Pilsen, Czech Republic Biomedical Centre, Biomedical Centre, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic
Department of Imaging Methods, Charles University Teaching Hospital Pilsen, Pilsen, Czech Republic.
Anticancer Res. 2015 Apr;35(4):2241-6.
The purpose of the present study was to evaluate the possibility of detection, staging and differentiation assessment of hepatocellular carcinoma (HCC) using a combination of dual-phase computed tomography (CT)-angiography in the arterial and portal phase with positron emission tomography (PET) imaging using (18)F-fluorodeoxyglucose ((18)FDG).
From a set of 10,000 patients who underwent (18)FDG-PET/CT, we examined a total of 65 patients (52 males, 13 females; mean age=61.7 years, ranging from 35-82 years) with HCC. The imaging included CT data acquisition after intravenous application of iodinated contrast material in arterial and portal phases, allowed to obtain data in CT angiography quality. Histological diagnosis of the resection sample (21), biopsy (37) or necropsy (7), including the evaluation of the hepatocytary origin of the tumor and the grade of its differentiation, was determined in all patients.
The most sensitive sign in the detection of HCC was the alternative presence of hypervascularity or hyperaccumulation of (18)F FDG that reached 93.8%. The high level of (18)F-FDG accumulation showed sensitivity of 84.1% and specificity of 75.0% for distinguishing between well- and poorly differentiated HCC.
The combination of the dual-phase CT angiography with (18)FDG PET helps in the assessment of staging and differentiation of HCC and has an important role in treatment decision-making.
本研究旨在评估联合使用动脉期和门静脉期双期计算机断层扫描（CT）血管造影与正电子发射断层扫描（PET）成像（使用（18）F-氟脱氧葡萄糖（（18）FDG））检测、分期及鉴别评估肝细胞癌（HCC）的可能性。
在一组接受（18）FDG-PET/CT检查的10,000例患者中，我们共检查了65例HCC患者（52例男性，13例女性；平均年龄=61.7岁，范围35 - 82岁）。成像包括在静脉注射碘化造影剂后动脉期和门静脉期进行CT数据采集，以获取CT血管造影质量的数据。所有患者均对切除样本（21例）、活检样本（37例）或尸检样本（7例）进行了组织学诊断，包括评估肿瘤的肝细胞起源及其分化程度。
检测HCC最敏感的征象是（18）F FDG的高血供或高摄取交替出现，其发生率达93.8%。（18）F-FDG的高摄取水平在鉴别高分化和低分化HCC方面的敏感性为84.1%，特异性为75.0%。
双期CT血管造影与（18）FDG PET联合应用有助于HCC的分期及鉴别评估，在治疗决策中具有重要作用。
