^(18)F-FDG PET/CT显像在肝细胞癌TACE术后残留或复发病灶检出中的应用价值  

Clinical application of ^(18)F-FDG PET/CT imaging in detecting residual lesions or recurrence foci of hepatocellular carcinoma after TACE treatment

作　　者：彭辽河[1] 胡晓燕[1] 李杰[1] 丁久荣[1] 邱大胜[1] 张建廷 魏崇健[3] 

机构地区：[1]武汉湖北省肿瘤医院PET/CT中心,430079 [2]湖北武警医院放射科介入诊疗室 [3]广州军区武汉总医院肿瘤微创介入治疗中心

出　　处：《介入放射学杂志》2012年第8期636-640,共5页Journal of Interventional Radiology

摘　　要：目的探讨^(18)F-FDG PET/CT显像在肝细胞癌(HCC)TACE术后残留或复发病灶检出中的应用价值。方法收集23例经TACE治疗后HCC残留或复发患者临床及PET/CT检查资料,患者均于TACE治疗后1.5～7个月行全身^(18)F-FDG PET/CT显像,1周内行DSA造影并接受介入治疗。重点评价2种检查方法对肿瘤残留或复发的显示能力。结果全组23例患者均顺利完成PET/CT显像检查及DSA造影检查。DSA造影证实肝内肿瘤残留或复发灶46个,PET/CT显像检出肝内肿瘤残留或复发灶共45个。以DSA作为参考标准,PET/CT显示肿瘤残留或复发灶的灵敏度为97.8%(45/46),特异度为100%,准确率为97.9%(46/47);PET/CT与DSA检出肿瘤残留或复发灶的结果比较差异无统计学意义(P>0.05);两者检出肿瘤灶的吻合度差异有统计学意义,且吻合度较强(系数k=0.657,P=0.000)。另外,^(18)F-FDG PET/CT全身显像新发现肝外转移3例,其中双肺转移1例,右侧肾上腺及肝门区、腹膜后区淋巴结转移1例,左髂骨转移1例。结论 ^(18)F-FDG PET/CT显像能够准确、直观地显示经TACE治疗后HCC残留或复发病灶,且真实性和可靠性好;同时^(18)F-FDG PET/CT全身显像检查是肿瘤远处转移探测最有效的方法,可较全面评估患者病情,协助临床确定个体化治疗方案具有重要价值。Objective To investigate the clinical application of 18F-FDG PET/CT imaging in detecting residual lesions or recurrence foci of hepatocellular carcinoma （HCC） after transcatheter arterial ehemoembolization （TACE）. Methods Twenty-three patients with residual lesions or recurrence loci of HCC underwent 18F-FDG PET/CT imaging within 1.5 - 7 months after TACE treatment. After 7 days DSA and interventional therapy were performed in all these patients. The findings of 18F-FDG PET/CT imaging were compared with the results of DSA. Taking the results of DSA as gold standard, the lesion-detecting sensitivity and specificity of 18F-FDG PET/CT imaging were analyzed and compared with those of DSA. Results 18F- FDG PET/CT and DSA were performed in all cases. DSA demonstrated 46 residual lesions and recurrent loci of HCC, while PET/CT imaging revealed 45 residual lesions and recurrent foci of HCC. Taking the results of DSA as reference standard, the lesion-detecting sensitivity, specificity and accuracy of 18F-FDG PET/CT were 97.8% , 100% and 97.9%, respectively. The differences in lesiondetecting sensitivity, specificity and accuracy between DSA and 18F-FDG PET/CT were not statistically significant （P 〉 0.05）. The DSA findingswere strongly consistent with 18F- FDG PET/CT results （k = 0.657, P = 0.000）. Moreover, 18F-FDG PET/CT imaging disclosed extrahepatic metastases in 3 cases,including metastasis of both lungs （n = 1 ）, metastasis of lymph nodes in right adrenal gland, hepatic hilum as well as in retroperitoneal region （n = 1）, and metastasis of left iliac bone （n = 1 ）. Conclusion The residual lesions or recurrence foci of HCC after TACE treatment can be clearly and directly displayed on ISF- FDG PET/CT imaging. Besides, 18F-FDG PET/CT whole body imaging appears to be a most effective method for the detection of distant metastasis, which can be used for making a comprehensive evaluation of the patient＇s condition. 18F-FDG PET/CT imaging is also very helpful in drawing up individualized thera

关 键 词：肝细胞癌 经动脉导管化疗栓塞术 体层摄影术 发射型计算机 体层摄影术 X线计算机 脱氧葡萄糖 

分 类 号：R735.7[医药卫生—肿瘤]