Usami Aya, Yokoyama Kota, Tsuchiya Junichi, Umezawa Yoshihiro, Toda Kazuma, Tateishi Ukihide, Yoshimura Ryoichi
Department of Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Department of Diagnostic Radiology and Nuclear Medicine, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Diagnostics (Basel). 2022 Feb 16;12(2):504. doi: 10.3390/diagnostics12020504.
A 44-year-old woman presented with high [F]FDG uptake liver lesion after six courses of R-CHOP and radiotherapy for abdominal DLBCL, which was misdiagnosed as a hepatic invasion. EOB-MRI showed slight T2 hyperintensity, low-intensity DWI, and decreased EOB uptake in the hepatocellular phase. Compared with the pretreatment planning CT, the liver lesion coincided with the area of >40.5 Gy, resulting in the diagnosis of RILD. At the follow-up [F]FDG PET/CT 7 months after irradiation, the abnormal liver uptake disappeared. Comparing [F]FDG PET/CT, EOB-MRI, and planning CT can lead to the correct diagnosis of RILD and avoid unnecessary biopsies and treatment changes.
一名44岁女性在接受6个疗程的R-CHOP方案化疗及腹部弥漫性大B细胞淋巴瘤放疗后,出现肝脏[F]FDG摄取增高灶,最初被误诊为肝侵犯。EOB-MRI显示T2加权像轻度高信号、扩散加权成像(DWI)低信号以及肝细胞期EOB摄取减低。与放疗前计划CT相比,肝脏病灶与接受超过40.5 Gy照射的区域相符,最终诊断为放射性肝损伤(RILD)。在放疗后7个月的随访[F]FDG PET/CT检查中,肝脏异常摄取消失。对比[F]FDG PET/CT、EOB-MRI及计划CT有助于RILD的正确诊断,避免不必要的活检及治疗方案更改。