PET-CT同机融合显像在肝癌TACE治疗后的应用价值  

Clinical Value of ^(18)F-FDG PET-CT Fusion Imaging in Hepatocellular Carcinoma after Transcatheter Arterial Chemoembolization with Lipiodol

作　　者：宋金龙[1] 邵文博[1] 丛宁[1] 

机构地区：[1]山东省肿瘤医院介入科,山东济南250117

出　　处：《实用放射学杂志》2007年第1期109-111,共3页Journal of Practical Radiology

摘　　要：目的探讨18F脱氧葡萄糖(FDG)PET-CT同机融合显像在肝动脉化疗栓塞(TACE)治疗原发性肝癌后的应用价值。方法15例原发性肝癌患者,肿瘤直径4~10cm,经TACE后3个月内完成18F-FDGPET-CT检查,与DSA和临床随访结果对照。结果15例患者TACE后PET显像均可见放射性缺损区,有11例肝内可见18F-FDG放射性增高灶,4例患者PET显像肝内未见明显18F-FDG放射性增高灶。18F-FDG放射性增高灶主要位于放射性缺损区周边,融合显像显示18F-FDG摄取增高灶与碘油沉积无对应关系。临床随访证实,11例18F-FDG摄取增高灶为残存肿瘤灶;经过再次TACE治疗或利用融合显像结果制定计划进行三维适形放疗后,18F-FDGPET-CT显像显示原18F-FDG浓聚灶范围缩小或消失。4例肝内未见明显18F-FDG放射性增高患者DSA显示肿瘤边缘仍有肿瘤染色。结论中晚期肝癌栓塞化疗后病灶边缘部分仍有肿瘤存活或残留,18F-FDGPET-CT显像可对大部分残存肿瘤定性定位,指导进一步治疗并监测疗效,但部分患者残存病灶18F-FDGPET-CT显像不能检出。Objective To discuss the clinical value of ^18F - FDG PET - CT fusion imaging in hepatocellular carcinoma after transcatheter arterial chemoembolization（ TACE ） with lipiodol. Methods 15 cases of hepatocellular carcinoma （ diameter 4 - 10 cm ） were investigated with ^18F - FDG PET - CT imaging within three months after TACE. The findings of imaging were compared with the results of anteriography and clinical follow - up. Results After TACE, regions of absent^18 F - FDG uptakes could be found in all 15 patients. Increased ^18F - FDG uptakes could be found in liver of 11 cases. The other 4 patients had no increased ^18F - FDG uptakes in liver. The regions of increased ^18F - FDG uptakes were residual viable tumor confirmed by anteriography and clinical follow - up , and most of them locate around region of absent ^18F - FDG uptakes. ^18F - FDG PET - CT fusion imaging showed that there were no correlation between increased ^18F - FDG uptakes and lipiodol dense distribution. After another TACE given or radiotherapy based on ^18F -FDG PET -CT fusion imaging, the areas of increased ^18F - FDG uptakes reduced or disappeared. In 4 patients without Increased ^18F - FDG uptakes , DSA showed that there were still viable tumor in the peripheral zone of tumor. Conclusion Residual viable tumor can still be found in patients with hepatocellular carcinoma after TACE. ^18 F -FDG PET -CT imaging can characterize and locate the most residual viable tumor, monitor response and be a guide in following therapy, but some viable tumor can not be found by ^18F - FDG PET - CT imaging.

关 键 词：肝癌 化疗栓塞 正电子发射体层摄影 体层摄影术 X线计算机 

分 类 号：R735.7[医药卫生—肿瘤] R818.051[医药卫生—临床医学]