摘要
目的评价18F-FDG PET/CT对介入治疗后残留病灶的作用;分析碘油沉积状态和肿瘤残留灶的关系;探讨18F-FDG PET/CT的应用范围及在介入治疗中的价值。方法22例结节型或巨块型原发性肝癌患者(平均最大径8.1 cm),在动脉栓塞化疗(TACE)或动脉栓塞化疗序贯联合射频消融(RFA)治疗后行18F-FDG PET/CT检查。检查结果阳性者,分析残留灶和沉积碘油的关系,并在PET-CT指导下对其作进一步的介入治疗。检查结果阴性者,用影像学和血清AFP随访6个月,以判断是否为真阴性。结果全组有21例患者经介入治疗后病灶内有碘油沉积。其中3例TACE后的病灶在有无碘油沉积的部位均可见残留灶。18例TACE序贯RFA治疗的病例中有11例存在残留灶,其中9例位于碘油沉积区和非碘油沉积区;2例残留灶仅存在于非碘油沉积区;另外7例PET/CT显示阴性,但其中1例经随访证实为假阴性。按照PET/CT所示的残留灶作进一步的介入治疗,又有5例存在残留灶的患者达到了局部根治。结论18F-FDG PET/CT对大肝癌介入治疗后的残留病灶探测具有较高的灵敏度。介入治疗后的病灶,无论是碘油沉积区还是非碘油沉积区都可能有残留病灶存在。18F-FDG PET/CT可以用于介入治疗后的疗效评价,并能对进一步的介入治疗起到靶向指导作用。
Objective To determine the sensitivity of fluorodeoxyglucose positron emission tomography/ computerized tomography （^18F-FDG-PET/CT） for detecting the residual HCC after interventional therapy and to analyze the lipiodol-accumulated and lipiodol-unaccumulated fields for localization of the residual tumor; together with exploration of field for ^18F-FDG-PET/CT in interventional therapy. Methods 22 HCC patients with average lesion diameter 8.1 cm received ^18F-FDG-PET/CT examination after transcatheter hepatic arterial chemoembolization （TACE） or the treatment of TACE following radiofrequency ablation（ RFA）. The findings of relation between residual and lipiodol-accumulated field could lead to perform more interventional therapy for the residual under PET-CT guidance. For patients with negative finding should be followed up with imaging examination and alpha-fetoprotein （AFP） for the sexelusion. Results The lesions of 21 cases showed more or less lipiodol deposition, including 3 cases with ^18F-FDG-PET/CT scanning after TACE which showed tracer concentrations indicating the existance of the residuals in the lipiodol-accumulated and lipiodol-unaccumulated fields. 18 cases received ^18F-FDG-PET/CT scanning after TACE following RFA showed residuals in 11. The residuals in 9 of the 11 cases distributed in the region of lipiodol-accumulated and lipiodol-unaccumulated fields and the residuals of the rest 2 cases only occurred in the lipiodol-unaccumulated area. The imagings of ^18F-FDG-PET/CT scanning for 9 cases were negative, but with falsenegative in 1 case. After all the sensitivity of ^18F-FDG-PET/CT scanning was 93.3 % . Moreover, another 5 cases with residual lesions achieved local radical therapy after RFA under ^18F-FDG-PET/CT guidance. Conclusions ^18F-FDG PET/CT has higher sensitivity for the detection of residuals of large HCC after interventional therapy. Residuals might exist in lipiodol-accumulated or lipiodol-unaccumulated fields and therefore ^18F-FDG PET/CT may provide the assessment for the therapeutic effect of HCC after interventional therapy and guidance for more treatments.
出处
《介入放射学杂志》
CSCD
2005年第6期588-591,共4页
Journal of Interventional Radiology
关键词
原发性肝癌
经动脉导管栓塞化疗
射频消融
正电子发射断层扫描
Primary hepatocellular carcinomas
Transcatheter hepatic arterial chemoembolization
Radiofrequency ablation
Positron emission tomography
