Hepatic superscan on fluorine-18 fluorodeoxyglucose PET/computed tomography imaging: a specific manifestation for diagnosing lymphoma or leukemia involvement.

OBJECTIVE

To explore whether the markedly fluorine-18 fluorodeoxyglucose (18F-FDG) uptake in the liver (named hepatic superscan) is a specific manifestation of malignant involvement.

METHODS

From January 2014 to June 2019, 23 patients with such presentations were retrospectively reviewed. 18F-FDG uptake was semiquantified using maximal standardized uptake value (SUVmax), liver to cerebellum (L/C) ratio, liver to mediastinum (L/M) ratio, mean standardized uptake value (SUVmean), peak standardized uptake value (SUVpeak), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). Some related laboratory examinations were also collected and analyzed. For comparison, 37 patients with mildly and moderately uptake in the liver were selected as the control group.

RESULTS

The hepatic SUVmax, L/C ratio, L/M ratio, SUVmean, MTV and TLG of the superscan group were significantly higher than that of mild- or moderate-uptake group (P < 0.005). Malignant hematological tumors accounted for 91.3% of the superscan group, which was significantly higher than 51.4% of mild- or moderate-uptake group (P = 0.004). β2-microglobulin was observed to be significantly higher in the superscan group compared with mild- or moderate-uptake group (P < 0.001), but not lactate dehydrogenase (LDH) (P = 0.409). On the contrary, C-reactive protein (CRP) was significantly higher in mild- or moderate-uptake group than that in the superscan group (P < 0.001).

CONCLUSION

Our study demonstrates that hepatic superscan is a strong indicator of malignant hematological tumors invading the liver.