Diagnostic value of F-18-FDG-PET/CT in indeterminate infiltrative hepatic lesions in an endemic area of viral hepatitis

作者：Cheng Mei Fang; Wu Yen Wen; Liu Kao Lang; Yen Ruoh Fang; Wu Yao Ming; Hsu Chiun; Chang Yu Ting; Tzen Kai Yuan; Wang Hsiu Po^*

来源：Nuclear Medicine Communications, 2011, 32(4): 252-259.

DOI：10.1097/MNM.0b013e32834368bf

• F-18-fluoro-2-deoxy-D-glucose
• dual-time point imaging
• infiltrative hepatic lesions
• positron emission tomography/computed tomography
• standardized uptake value

Background and aim Infiltrative hepatic lesions in conventional imaging modalities are a continuing diagnostic challenge in clinical practice, especially in an endemic area of viral hepatitis. The purpose of this study is to prospectively assess the role of F-18-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) in indeterminate infiltrative hepatic lesions seen in conventional CT or magnetic resonance imaging (MRI).
Methods Dual-phase FDG-PET/CT was performed on 35 consecutive patients with indeterminate infiltrative hepatic lesions in CT or MRI. The variables analyzed included visual score and maximum standardized uptake value. Final diagnosis was histopathology or clinical follow-up for at least 12 months.
Results Malignancy was proven in 28 patients and there were benign strictures in seven patients. Sensitivity, specificity, and overall diagnostic accuracy of FDG-PET/CT using visual score were 85.7% (24/28), 71.4% (5/7), and 82.9% (29/35). Early and delayed maximum standardized uptake values were significantly higher in infiltrative hepatic malignancies than in benign lesions. Furthermore, PET/CT detected 13 unexpected distant metastatic foci not seen in other imaging studies. Thirteen patients (37.1%) had the plans of clinical treatment altered by FDG-PET/CT alone.
Conclusion FDG-PET/CT can help to clarify the diagnosis of indeterminate infiltrative hepatic lesions in CT or MRI. In this patient population, FDG-PET/CT may hold promise in the detection of unsuspected occult metastases, facilitating decision making and treatment planning.

• 出版日期2011-4