Catalano Orlando, Sandomenico Fabio, Vallone Paolo, Setola Sergio Venanzio, Granata Vincenza, Fusco Roberta, Lastoria Secondo, Mansi Luigi, Petrillo Antonella
Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
Department of Radiology, National Cancer Institute, Fondazione Pascale, Naples, Italy.
Ultrasound Med Biol. 2016 Nov;42(11):2717-2723. doi: 10.1016/j.ultrasmedbio.2016.06.023. Epub 2016 Aug 2.
Widespread use of fluorodeoxyglucose-positron emission tomography (PET) in cancer imaging may result in a number of indeterminate and false-positive findings. We investigated the role of contrast-enhanced ultrasound (CEUS) as a second-level option after inconclusive PET. We reviewed CEUS images acquired over 4 y, selecting the examinations performed specifically to better assess an unclear PET image. Final diagnosis was confirmed by biopsy, surgery, further imaging or follow-up. Seventy CEUS examinations were performed after a PET scan (44 PET examinations, 19 PET-computer tomography [CT] examinations and 7 PET-CECT examinations). The target organ was the liver in 54 cases, spleen in 12, gallbladder in 2 and pancreas and kidney in one each. In 6 of 70 cases, CEUS was performed because of a negative PET (no uptake) despite an abnormal finding on the CT images of the PET-CT study; CEUS allowed a correct diagnosis in all of these. In 20 of 70 cases, the PET findings were categorized as indeterminate and non-specific (non-specific fluorodeoxyglucose uptake in PET report with no standardized uptake value given); CEUS reached a correct diagnosis in 19 of the 20 cases with one false negative. In 34 of 70 cases, PET was indeterminate, but specific (fluorodeoxyglucose uptake with a standardized uptake value provided); CEUS reached a correct diagnosis in 30 of these 34 cases. In 10 of 70 cases, PET was categorized as determinate but to be investigated because of discrepancy with clinical or imaging findings; CEUS a definitive diagnosis in 9 of 10 cases. CEUS proved to be effective option in the assessment of cancer patients with indeterminate PET findings.
氟脱氧葡萄糖 - 正电子发射断层扫描（PET）在癌症成像中的广泛应用可能会导致一些不确定和假阳性结果。我们研究了超声造影（CEUS）作为PET检查结果不明确后的二级检查手段的作用。我们回顾了4年期间获取的CEUS图像，选择那些专门为更好地评估不明确的PET图像而进行的检查。最终诊断通过活检、手术、进一步成像或随访得以证实。在PET扫描后进行了70次CEUS检查（44次PET检查、19次PET - 计算机断层扫描[CT]检查和7次PET - CECT检查）。靶器官为肝脏的有54例，脾脏12例，胆囊2例，胰腺和肾脏各1例。在70例中有6例，尽管PET - CT研究的CT图像有异常发现，但由于PET结果为阴性（无摄取）而进行了CEUS检查；在所有这些病例中，CEUS都做出了正确诊断。在70例中有20例，PET检查结果被归类为不确定且非特异性（PET报告中氟脱氧葡萄糖摄取非特异性，未给出标准化摄取值）；在这20例中，CEUS在19例中做出了正确诊断，1例假阴性。在70例中有34例，PET结果不确定但具有特异性（给出了标准化摄取值的氟脱氧葡萄糖摄取）；在这34例中的30例中，CEUS做出了正确诊断。在70例中有10例，PET结果被归类为明确，但由于与临床或影像学发现存在差异而需进一步检查；在这10例中的9例中，CEUS做出了明确诊断。对于PET检查结果不确定的癌症患者，CEUS被证明是一种有效的检查手段。
