| 11C-乙酸盐PET/CT显像在中、高分化肝细胞肝癌复发与转移监测中的应用研究 |
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| 引用本文： | 麻广宇,刘家金,徐白萱,陈英茂,张晓军,刘健,张锦明. 11C-乙酸盐PET/CT显像在中、高分化肝细胞肝癌复发与转移监测中的应用研究[J]. 国际放射医学核医学杂志, 2018, 42(4): 312-316. DOI: 10.3760/cma.j.issn.1673-4114.2018.04.004 |
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| 作者姓名： | 麻广宇 刘家金 徐白萱 陈英茂 张晓军 刘健 张锦明 |
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| 作者单位： | 100853 北京, 中国人民解放军总医院核医学科 |
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| 摘 要： | 目的探讨11C-乙酸盐PET/CT显像在中、高分化肝细胞肝癌（HCC）复发与转移监测中的应用价值。方法回顾性分析2015年1月至2016年12月行11C-乙酸盐和18F-FDG PET/CT躯干显像的10例中、高分化HCC男性患者，其中，中分化HCC 6例，高分化HCC 4例。患者经手术或介入治疗后，甲胎蛋白进行性升高，比较11C-乙酸盐和18F-FDG PET/CT的诊断价值。PET图像上代谢高于正常肝脏组织的病灶判定为阳性，低于或类似于正常肝脏组织的病灶判定为阴性。通过勾画感兴趣区计算病灶及本底最大标准化摄取值（SUVmax）及靶/本底比值（T/B）。所有患者最终通过病理或影像学检查确诊转移或复发。结果11C-乙酸盐显像发现18个阳性病灶，灵敏度为100%（18/18）；18F-FDG显像发现5个阳性病灶，灵敏度为27.8%（5/18）；两种示踪剂同时发现5个阳性病灶（在4例中分化HCC患者中），11C-乙酸盐显像探测病灶的灵敏度与两种示踪剂联合显像相同。11C-乙酸盐显像病灶SUVmax为1.3~14.2，T/B为1.1~14.3；18F-FDG显像病灶SUVmax为0.5~3.4，T/B为0.6~1.1。8例患者（13个病灶）病理证实为肿瘤复发或转移，2例患者（5个病灶）3个月后复查PET/CT或CT证实为转移。结论11C-乙酸盐显像可显著提高中、高分化HCC复发与转移诊断的灵敏度；推荐使用11C-乙酸盐显像用于监测中、高分化HCC的复发与转移。
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| 关 键 词： | 癌，肝细胞 氟脱氧葡萄糖F18 乙酸盐类 正电子发射断层显像计算机体层摄影术 |
| 收稿时间： | 2018-01-12 |
Application of 11C-acetate PET/CT imaging in the detection of recurrence and metastasis of hepatocellular carcinoma with intermediate and high differentiation |
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| Guangyu Ma,Jiajin Liu,Baixuan Xu,Yingmao Chen,Xiaojun Zhang,Jian Liu,Jinming Zhang. Application of 11C-acetate PET/CT imaging in the detection of recurrence and metastasis of hepatocellular carcinoma with intermediate and high differentiation[J]. International Journal of Radiation Medicine and Nuclear Medicine, 2018, 42(4): 312-316. DOI: 10.3760/cma.j.issn.1673-4114.2018.04.004 |
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| Authors: | Guangyu Ma Jiajin Liu Baixuan Xu Yingmao Chen Xiaojun Zhang Jian Liu Jinming Zhang |
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| Affiliation: | Department of Nuclear Medicine, Chinese PLA General Hospital, Beijing 100853, China |
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| Abstract: | ObjectivesTo investigate the value of 11C-acetate PET/CT imaging in the detection of the recurrence and metastasis of hepatocellular carcinoma (HCC) with high or medium differentiation.MethodsA total of 10 patients who underwent surgical or interventional therapy, had moderately or highly differentiated HCC, underwent 11C-acetate and 18F-FDG PET/CT trunk imaging from January 2015 to December 2016 were retrospectively analyzed. Progressive increases in alpha fetoprotein were observed in the patients after the treatment. 11C-acetate and 18F-FDG PET/CT scan were performed on the patients in one week, and the diagnostic values of the two tracers were compared. In the PET images, the lesion was positive when the metabolic level of the lesion was higher than that of a normal liver tissue and negative when the metabolic level of the lesion was lower than or same as that of a normal liver tissue. The maximum standardized uptake value(SUVmax) and the ratio of target to background(T/B) were calculated by outlining the areas of interest. All patients were diagnosed with metastasis or recurrence by pathology or imaging examination.ResultsSix patients had moderately differentiated HCC and four patients had highly differentiated HCC. 11C-acetate imaging revealed 18 positive lesions, and the sensitivity was 100%(18/18). Five positive lesions were found in 18F-FDG images, and the sensitivity was 27.8%(5/18). Two tracers revealed five positive lesions (in four patients with moderately differentiated HCC). The sensitivity of 11C-acetate imaging to detect lesions was the same as that of double tracers combined imaging. The SUVmax range of 11C-acetate imaging was 1.3-14.2, and the range of T/B was 1.1-14.3. The SUVmax range of 18F-FDG imaging was 0.5-3.4, and the range of T/B was 0.6-1.1. Eight patients (13 lesions) were pathologically confirmed to have tumor recurrence or metastasis, and two patients (5 lesions) proved to be metastatic after 3 months of follow-up.Conclusions11C-acetate imaging can significantly improve the sensitivity of the diagnosis of recurrence and metastasis of moderately and highly differentiated HCC. 11C-acetate imaging is expected to replace 18F-FDG imaging in monitoring recurrence and metastasis in moderately and highly differentiated HCC. |
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