Kutaiba Numan, Ardalan Zaid, Patwala Kurvi, Lau Eddie, Goodwin Mark, Gow Paul
Radiology Department, Austin Health, Melbourne, Victoria, Australia.
Liver Transplant Unit, Austin Health, Melbourne, Victoria, Australia.
Transplant Direct. 2018 Nov 23;4(12):e408. doi: 10.1097/TXD.0000000000000846. eCollection 2018 Dec.
The purpose of this study was to review the value of bone scans (BS) in the assessment of bone metastases from early-stage hepatocellular carcinoma (HCC) in patients assessed or waiting for liver transplant (LTx).
We reviewed BS studies performed at our center for patients with early-stage HCC either being assessed for LTx, or on the waiting list for LTx, from January 2010 to May 2017. The BS findings were classified as positive, equivocal, or negative. Correlation with final outcome based on clinical and radiological follow-up was performed.
There were 360 BS performed in 186 patients during the study period with a mean age of 58.7 years (range, 34.9-70.4 years) and most were male patients (161/186 [86.6%]). None of the BSs resulted in delisting of patients from the LTx waiting list. Three BSs were reported as positive for metastases. All 3 were proven to be false positives on follow-up. Fourteen studies reported equivocal findings, none of which were confirmed to be metastases on follow-up. There was 1 false-negative BS: a bone metastasis was detected incidentally on magnetic resonance imaging and proven on biopsy.
We have demonstrated that the diagnostic yield of BS in early HCC patients who are candidates for LTx is minimal, challenging the current inclusion of BS in guidelines for staging these HCC patients.
本研究的目的是回顾骨扫描（BS）在评估接受肝移植（LTx）评估或等待肝移植的早期肝细胞癌（HCC）患者骨转移中的价值。
我们回顾了2010年1月至2017年5月在本中心对接受LTx评估或在LTx等待名单上的早期HCC患者进行的BS研究。BS结果分为阳性、可疑或阴性。基于临床和影像学随访与最终结果进行相关性分析。
在研究期间，186例患者共进行了360次BS，平均年龄58.7岁（范围34.9 - 70.4岁），大多数为男性患者（161/186 [86.6%]）。没有一次BS导致患者从LTx等待名单中除名。有3次BS报告为转移阳性。所有3次在随访中均被证明为假阳性。14项研究报告了可疑结果，随访中均未证实为转移。有1次BS为假阴性：磁共振成像偶然发现骨转移并经活检证实。
我们已经证明，对于LTx候选的早期HCC患者，BS的诊断率极低，这对目前将BS纳入这些HCC患者分期指南提出了挑战。
