Tulin P E, Dolgushin M B, Odzharova A A, Mikhaylov A I, Medvedeva B M, Shiryaev S V, Dolgushin B I
1Department of positron emission tomography of N.N. Blokhin Russian Cancer Research Center, Kashirskoe shosse, 23, Moscow, 115478 Russia.
ICERR FSBSI N.N. Blokhin RCRC, Moscow, Russia.
Eur J Hybrid Imaging. 2017;1(1):13. doi: 10.1186/s41824-017-0018-7. Epub 2017 Dec 1.
The purpose of the study to evaluate possibilities of CT-perfusion and PET methods with 18F-FDG and 18F-fluorocholine in the complex diagnosis of hepatocellular carcinoma. The study included the results of PET/CT with 18F-FDG, 18F-FCh and CT-perfusion of the liver in 18 patients with histologically confirmed diagnosis of hepatocellular carcinoma (HCC). Depending on the degree of tumor differentiation, all patients were divided into 3 groups - patients with highly differentiated (6 patients), moderately differentiated (4 patients), and low-differentiated HCC (8 patients).
Average values of maxSUV in the group of patients with highly differentiated HCC in PET/CT with 18F-FDG and 18F- fluorocholine in a solid component of tumor reached 3.51 and 18.24, respectively; in patients with moderately differentiated HCC - 3.91 and 12.32, respectively; in patients with low-differentiated HCC - 9.58 and 9.70, respectively. Average values of CT perfusion imaging in a solid component of the tumor in the group of patients with highly differentiated HCC were the following: BF - 55,33 ml/100 ml/min, BV - 13,71 ml/100 ml, ALP - 52,41 ml/100 ml/min, PVP - 10.81 ml/100 ml/min ( ≤ 0,05), in the group of patients with moderately differentiated HCC: BF - 52,78 ml/100 m /min, BV - 12,23 ml/100 ml, ALP - 47,26 ml/100 ml/min, PVP - 9,10 ml/100 ml/min ( ≤ 0.05), in the solid component of low-differentiated HCC: BF - 46,96 ml/100 ml/min, BV - 9,49 ml/100 ml, ALP - 40.54 ml/100 ml/min, PVP - 7,66 ml/100 ml/min ( ≤ 0,05).
The diagnostic capabilities of the complex of PET/CT techniques with 18F-FDG and 18F-FCh and CT perfusion in a single-scan mode for hepatocellular carcinoma were evaluated for the first time. The obtained data allow to assume that the integrated use of PET with 18F-FDG and 18F-FCh and CT perfusion in a single scan improves the differential diagnostic possibilities of PET/CT diagnostics, which can find application in planning and prognosis of the disease. Due to the small number of patients further study of the problem is required.
本研究旨在评估CT灌注成像以及18F-FDG和18F-氟胆碱PET方法在肝细胞癌综合诊断中的应用可能性。该研究纳入了18例经组织学确诊为肝细胞癌(HCC)患者的18F-FDG、18F-FCh PET/CT及肝脏CT灌注成像结果。根据肿瘤分化程度,将所有患者分为3组——高分化患者(6例)、中分化患者(4例)和低分化HCC患者(8例)。
在PET/CT检查中,高分化HCC患者组肿瘤实性成分中18F-FDG和18F-氟胆碱的最大标准摄取值(maxSUV)平均值分别为3.51和18.24;中分化HCC患者分别为3.91和12.32;低分化HCC患者分别为9.58和9.70。高分化HCC患者组肿瘤实性成分的CT灌注成像平均值如下:血流量(BF)-55.33ml/100ml/min,血容量(BV)-13.71ml/100ml,平均通过时间(MTT)-52.41ml/100ml/min,峰值血容量(PVP)-10.81ml/100ml/min(≤0.05);中分化HCC患者组:BF-52.78ml/100ml/min,BV-12.23ml/100ml,MTT-47.26ml/100ml/min,PVP-9.10ml/100ml/min(≤0.05);低分化HCC实性成分:BF-46.96ml/100ml/min,BV-9.49ml/100ml,MTT-40.54ml/100ml/min,PVP-7.66ml/100ml/min(≤0.05)。
首次评估了18F-FDG和18F-FCh PET/CT技术联合CT灌注成像在单次扫描模式下对肝细胞癌的诊断能力。所得数据表明,18F-FDG和18F-FCh PET与CT灌注成像在单次扫描中的联合应用提高了PET/CT诊断的鉴别诊断能力,可应用于疾病的规划和预后评估。由于患者数量较少,需要对该问题进行进一步研究。