摘要
目的评价^(18)F-FDG PET/CT 探测原发性肝细胞肝癌(HCC)肺转移的价值,并分析肺转移灶 FDG 摄取假阴性的原因。方法 32例经手术病理或临床随访证实为 HCC 肺转移的患者行^(18)F-FDG PET/CT 检查,根据 FDG 摄取阳性或阴性分为2组:A 组18例,肺转移灶表现为 FDG 摄取增高;B组14例,肺转移灶表现为无 FDG 摄取。结果 32例 HCC 肺转移患者中,27例^(18)F-FDG PET/CT 显像发现肝内高代谢病灶,12例伴发其他肝外转移,其中包括腹膜后淋巴结、肺门或纵隔淋巴结、骨骼转移。PET 对最大径<10 mm 的肺转移灶探测灵敏度为35.6%,对最大径≥10 mm 的肺转移灶探测灵敏度为63.6%,两者比较,差异有统计学意义(χ~2=4.712,P=0.03)。肺转移灶的 FDG 摄取变异较大,从无 FDG 摄取到少数病灶的显著 FDG 摄取,83.3%(25/30)摄取阳性的转移灶最大 SUV(SUV_(max))≤3。结论 HCC 肺转移灶 FDG 摄取假阴性率较高,除与病灶大小有关外,可能与原发病灶的病理特点有关。呼吸控制的薄层 CT 图像以及必要时增强 CT 对肺部小结节的检出非常重要,对CT 显示小的肺结节病灶应严密随访。
Objective The purpose of this study was to evaluate the usefulness of PET/CT in detecting lung metastases from primary hepatocellular carcinoma （ HCC）, and to analyze the false negative metastases with no uptake of FDG. Methods Thirty-two patients with lung metastases from HCC confirmed by histopathology examination or clinical follow-up were included in this study. The patients were categorized into group A, 18 patients having positive uptake of FDG; and group B, 14 patients being negative in FDG uptake. The patients received 18^ F-FDG intravenously after fasting for 4 to 6 h. Three-dimensional whole body PET/CT scans were acquired 60 min after injection. Results Twenty-seven of thirty-two patients showed hypermetabolic lesions in liver, indicating recurrence or viable tumor of hepatoceUular carcinoma. Twelve of thirty-two patients had other extrahepatic metastases, including post peritoneum, hilar and mediastinal lymph nodes and bone. The sensitivity of 18^ F-FDG PET was 35.6% for lung metastases smaller than 10 mm and 63.6% for lesions larger. The FDG uptake in the lung metastases was variable, 83.3% positive lung metastases had relatively lower FDG uptake with maximum SUV less than or equal to 3. Condusions This preliminary study showed that higher false negative rate of FDG uptake in lung metastases. It might be attributed to the smaller size and pathological characteristics of the lesions. Thin slice, contrast enhanced CT with breath-hold or careful clinical follow-up was recommended for detection of small lung metastases.
出处
《中华核医学杂志》
CAS
CSCD
北大核心
2007年第3期143-146,共4页
Chinese Journal of Nuclear Medicine
