PET/Ce-CT/DW-MRI融合成像在肝脏局灶性病变评估中的附加价值：肝脏局灶性病变的PET/Ce-CT/DW-MRI融合成像

The added value of PET/Ce-CT/DW-MRI fusion in assessment of hepatic focal lesions: PET/Ce-CT/DW-MRI fusion in hepatic focal lesion.

作者信息

Salem Shahenda, Houseni Mohamed, Zidan Lamiaa, Kandil Ahmed

机构信息

Nuclear Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.

Radiology Department, Faculty of Medicine, National Liver Institute-Menofia University, Menofia, Egypt.

出版信息

Nucl Med Biol. 2015 Jul;42(7):637-42. doi: 10.1016/j.nucmedbio.2015.03.010. Epub 2015 Apr 6.

DOI:10.1016/j.nucmedbio.2015.03.010

PMID:25907467

Abstract

INTRODUCTION

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.

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

The addition of DW-MRI to PET/Ce-CT is valuable in the characterization of hepatic focal lesions.

摘要

引言

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。

目的

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。

方法

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。

结果

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%。