Salem Shahenda, Houseni Mohamed, Zidan Lamiaa, Kandil Ahmed
Nuclear Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Radiology Department, Faculty of Medicine, National Liver Institute-Menofia University, Menofia, Egypt.
Nucl Med Biol. 2015 Jul;42(7):637-42. doi: 10.1016/j.nucmedbio.2015.03.010. Epub 2015 Apr 6.
The liver hosts a variety of benign and malignant tumors. Accurate diagnosis can be challenging in certain cases, especially in patients with a history of malignancy or in those with underlying liver pathology, such as cirrhosis.
To evaluate the added clinical value of multi-modality liver imaging utilizing PET/Ce-CT/DW-MRI for characterization of hepatic focal lesions (HFL) and compare it with each diagnostic modality when interpreted alone.
The study included 35 patients with HFL. They were 7 females & 28 males; their age ranged from 41 to 78years, all patients underwent PET/Ce-CT and DW-MRI scans. Ce-CT, PET and DW-MR images were reviewed independently, and then combined PET/Ce-CT, PET/DW-MRI and PET/Ce-CT/DW-MRI scans were analyzed. The results were correlated with histopathology or clinical/imaging follow-up.
The 35 patients had 98 focal lesions. Fifty-three lesions were finally diagnosed as primary hepatocellular carcinoma, 18 lesions were metastases, 7 lesions were lymphoma and 20 lesions were benign. On a patient based analysis; the sensitivity, specificity, PPV, NPV and accuracy were 100%, 67%, 94%, 100% and 94% for PET/Ce-CT compared to 97%, 83%, 97%, 83% and 94 % for DW-MRI, respectively. Combined PET/Ce-CT/DW-MR scans raise those parameters up to 100%. On a lesion based analysis; the sensitivity, specificity, PPV, NPV and accuracy were 94%, 75%, 94%, 75%, 90% for PET/Ce-CT compared to 94%, 95%, 99%, 97% and 94 % for DW-MRI, respectively. All these parameters were 100 % with PET/Ce-CT/DW-MRI.
The addition of DW-MRI to PET/Ce-CT is valuable in the characterization of hepatic focal lesions.
肝脏存在多种良性和恶性肿瘤。在某些情况下，准确诊断可能具有挑战性，尤其是在有恶性肿瘤病史的患者或有潜在肝脏病变（如肝硬化）的患者中。
评估利用PET/Ce-CT/DW-MRI进行多模态肝脏成像对肝局灶性病变（HFL）特征描述的附加临床价值，并将其与单独解读时的每种诊断模态进行比较。
该研究纳入了35例HFL患者。其中女性7例，男性28例；年龄在41至78岁之间，所有患者均接受了PET/Ce-CT和DW-MRI扫描。分别独立回顾Ce-CT、PET和DW-MR图像，然后分析联合的PET/Ce-CT、PET/DW-MRI和PET/Ce-CT/DW-MRI扫描。结果与组织病理学或临床/影像学随访结果相关。
35例患者共有98个局灶性病变。最终诊断为原发性肝细胞癌的病变有53个，转移瘤18个，淋巴瘤7个，良性病变20个。在基于患者的分析中；PET/Ce-CT的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为100%、67%、94%、100%和94%，而DW-MRI分别为97%、83%、97%、83%和94%。联合PET/Ce-CT/DW-MR扫描使这些参数提高到100%。在基于病变的分析中；PET/Ce-CT的敏感性、特异性、阳性预测值、阴性预测值和准确性分别为94%、75%、94%、75%、90%，而DW-MRI分别为94%、95%、99%、97%和94%。PET/Ce-CT/DW-MRI的所有这些参数均为100%。
在PET/Ce-CT中加入DW-MRI对肝局灶性病变的特征描述很有价值。
