~(11)C-胆碱联合~(18)F-FDG PET-CT 诊断肝细胞肝癌的价值
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摘要
目的探究~(11)C-胆碱联合~(18)F-FDG PET-CT在诊断肝细胞肝癌中的临床价值。方法将临床诊断为肝细胞肝癌(HCC)的21例患者经~(11)C-胆碱和~(18)F-FDG PET-CT联合显像后,均经手术或穿刺经组织病理学分型,半定量分析采用SUVmax、肿瘤/肝(T/L)比值等指标。结果 21例肝细胞肝癌患者中,22个病灶,高分化8例,~(11)C-胆碱显像阳性7例,~(18)F-FDG显像阳性1例;中分化7例,~(11)C-胆碱显像阳性6例,~(18)F-FDG显像阳性1例;低分化7例,~(11)C-胆碱显像阳性2例,~(18)F-FDG显像阳性7例。结论 ~(11)C-胆碱联合~(18)F-FDG PET-CT显像能够提高HCC的检出率,给评估肿瘤恶性程度提供有价值的信息。
Objective To investigate the clinical value of ~(11)C-choline combined with ~(18)F-FDG PET-CT in the diagnosis of hepatocellular carcinoma(HCC). Methods 21 patients with clinically diagnosedHCC were examined by ~(11)C-choline and ~(18)F-FDG PET-CT combined imaging, and classified by operation or puncture after PET-CT double combined imaging. SUVmax and tumor/liver(T/L) ratio were used for semi-quantitative analysis. Results There were 22 lesions in 21 patients with hepatocellular carcinoma(HCC). In 8 cases of high differentiation, 7 cases were positive for ~(11)C-choline imaging and 1 case was positive for ~(18)F-FDG imaging. In 7 cases of moderate differentiation, 6 cases were positive for ~(11)C-choline imaging and 1 cases were positive for ~(18)F-FDG imaging. In 7 cases of poorly differentiated, 2 cases were positive for ~(11)C-choline imaging and 7 cases were positive for ~(18)F-FDG imaging. Conclusion ~(11)C-choline combined with ~(18)F-FDG PET-CT imaging can improve the detection rate of HCC and provide information for evaluating the malignant degree of tumor.
Objective To investigate the clinical value of ~(11)C-choline combined with ~(18)F-FDG PET-CT in the diagnosis of hepatocellular carcinoma(HCC). Methods 21 patients with clinically diagnosedHCC were examined by ~(11)C-choline and ~(18)F-FDG PET-CT combined imaging, and classified by operation or puncture after PET-CT double combined imaging. SUVmax and tumor/liver(T/L) ratio were used for semi-quantitative analysis. Results There were 22 lesions in 21 patients with hepatocellular carcinoma(HCC). In 8 cases of high differentiation, 7 cases were positive for ~(11)C-choline imaging and 1 case was positive for ~(18)F-FDG imaging. In 7 cases of moderate differentiation, 6 cases were positive for ~(11)C-choline imaging and 1 cases were positive for ~(18)F-FDG imaging. In 7 cases of poorly differentiated, 2 cases were positive for ~(11)C-choline imaging and 7 cases were positive for ~(18)F-FDG imaging. Conclusion ~(11)C-choline combined with ~(18)F-FDG PET-CT imaging can improve the detection rate of HCC and provide information for evaluating the malignant degree of tumor.
引文
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[2] LIM J H,KIM C K,LEE W J,et al.Detection of hepatocellular carcinomas and dysplasticnodules in cirrhotic livers:accuracy of helical CT in transplant pattents[J].AJR Am Roentgenol,2000,175(2):693-698.
[3] ROHREN E M,TURKINGTON T G,COLEMAN R E.Clinical applications of PET in oncology[J].Radiology,2004,231(9):305-332.
[4] 尚玉锟,谢明壹,孔令山.PET 在肝脏肿瘤诊断中的应用及研究进展[J].中华国际医学杂志,2002,2(1):76-78.
[5] IWATA Y,SHIOMI S,SASAKI N,et al.Clinical usefulness of positron emission tom-ography with fluorine-18-fluorodeoxyglucose in the diagnosis of liver tumors[J].Ann Nucl Med,2000,14(2):121-126.
[6] TORIZUKA T,TAMAKI N,INOKUMA T,et al.In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET[J].Nucl Med,1995,36(6):1811-1815.
[7] HARA T,KOSAKA N,SHINOUTA N.PET imaging of brain tumor with [met-hyl-11C] choline[J].Nucl Med,1997,38(9):842-847.
[8] BERTAGNA F,BERTOLI M,BOSIO G,et al.Diagnostic role of radiolabelled choline PET or PET/CT in hepatocellular carcinoma:a systematic review and meta ana-lysis[J].Hepatol Int,2014,8(3):493-500.
[9] POPPER H.American association for the study of liver diseases[J].Hepatology,1992,16(4):291-292.
[10] DELBEKE D,MARTIN W H,SADLER M P,et al.Evaluation of benign vs malignant hepatic lesions with positron emission tomography[J].Arch Surg,1998,133(11):510-516.
[11] HUEBNER R H,PARK K C,SHEPHERD J E,et al.A meta analysis of theliterature for Whole body FDG PET detection of recurrent colorectal cancer[J].Nucl Med,2000,41(11):1177-1189.
[12] TROJAN J,SCHROEDER O,RAEDLE J,et al.Fluorine-18 FDG positron emission tomography for imaging of hepatocellular carcinoma[J].Am J Gastroenterol,1999,94(10):3314-3319.
[13] OKAZUMI S,ISONO K,ENOMOTO K,et al.Evaluation of liver tumors using fluo-rine-18-fluorodeoxyglucose PET:characterization of tumor and asse-ssment of effect of treatment[J].Nucl Med,1992,33(3):333-339.
[14] TORIZUKA T,KANNO T,FUTATSUBASHI M,et al.Imaging of gynecologic tumors:comparison of 11C-choline PET with 18F-FDG PET[J].Nucl Med,2003,44(1):1051-1056.
[15] 许靖,张奇洲,秦永德,等.11C-CFT脑多巴胺转运体PET显像在不同类型帕金森病患者病情评估中的应用价值[J].新疆医科大学学报,2017,40(6):42-46.
[16] WU H,WANG Q,LI B,et al.F-18 FDG in conjunction with 11C-choline PET/CT in the diagnosis of hepatocellular carcinoma[J].Clin Nucl Med,2011,36(12):1092-1097.
[17] KUANG Y,SALEM N,TIAN H,et al.Imaging lipid synthesis in hepatocellular carcinoma with [methyl-11C]choline:correlation with in vivo metabolic studies[J].Nucl Med,2011,52(3):98-106.
[18] HO C L,YU S C,YEUNG D W.11C-acetate PET imaging in hepatocellularcarcinoma and other liver masses[J].Nucl Med,2003,44(7):213-221.
[19] HO C L,CHEN S,YEUNG D W,et al.Dualtracer PET/CT imaging in evaluation of metastatic hepatocellular carcinoma[J].Nucl Med,2007,48(7):902-909.