Diagnostic value of 18F-FDG-PET/CT in indeterminate infiltrative hepatic lesions in an endemic area of viral hepatitis
Journal
Nuclear Medicine Communications
Journal Volume
32
Journal Issue
4
Pages
252-259
Date Issued
2011
Author(s)
Abstract
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 isto prospectively assess the role of F-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 on35consecutive patients with indeterminate infiltrative hepatic lesions in CT or MRI. The variables analyzed included visual score and maximum standardized uptakevalue. Final diagnosis was histopathology orclinicalfollow-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 notseen 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. Inthis patient population, FDG-PET/CT may hold promisein the detection of unsuspected occult metastases, facilitating decision making and treatment planning. ? 2011 Wolters Kluwer Health | Lippincott Williams &Wilkins.
Other Subjects
alpha fetoprotein; bilirubin; CA 19-9 antigen; fluorodeoxyglucose f 18; diagnostic agent; fluorodeoxyglucose f 18; radiopharmaceutical agent; adult; aged; article; bile duct carcinoma; bilirubin blood level; clinical article; computer assisted tomography; controlled clinical trial; diagnostic accuracy; diagnostic test accuracy study; diagnostic value; distant metastasis; drug uptake; false negative result; false positive result; feasibility study; female; follow up; hepatitis B; hepatitis C; histopathology; human; human tissue; liver cancer; liver cirrhosis; liver disease; liver metastasis; lymph node metastasis; male; mediastinum lymph node; nuclear magnetic resonance imaging; positron emission tomography; predictive value; primary sclerosing cholangitis; prospective study; protein blood level; receiver operating characteristic; sensitivity and specificity; spine metastasis; treatment planning; virus hepatitis; computer assisted emission tomography; computer assisted tomography; diagnostic imaging; differential diagnosis; endemic disease; liver tumor; methodology; middle aged; Taiwan; virus hepatitis; Adult; Aged; Aged, 80 and over; Diagnosis, Differential; Diagnostic Imaging; Endemic Diseases; Female; Fluorodeoxyglucose F18; Hepatitis, Viral, Human; Humans; Liver Neoplasms; Male; Middle Aged; Positron-Emission Tomography; Prospective Studies; Radiopharmaceuticals; Sensitivity and Specificity; Taiwan; Tomography, Emission-Computed; Tomography, X-Ray Computed
Type
journal article