^18F-FDG PET／CT在肝脏肿瘤介入治疗后的临床意义

目的：评价^18F-脱氧葡萄糖（FDG）PET／CT显像在肝动脉化疗栓塞（TACE）术后疗效的价值。方法：22例肝肿瘤患者（男19例，女3例，年龄31—65岁，平均52岁）TACE术后4周～1．5年行^18F-FDGPET／CT检查，22例均经病理或随访证实。结果：22例患者40个肝内病灶。①平扫CT：碘油全瘤均匀致密型沉积11个病灶，碘油不均匀型沉积29个病灶；②^18F-FDGP田显像：放射性分布缺损或稀疏8个病灶，放射性浓聚20个病灶，放射性分布与邻近正常肝实质相近12个病灶（2个病灶SUVratio〈0．6，10个病灶SUVratio〉0．6）；③^18F--FDGPET／CT显像：全瘤均匀致密碘油沉积并放射性分布缺损或稀疏8个病灶，全瘤均匀致密碘油沉积并瘤灶放射性分布与邻近肝实质相近3个病灶（2个病灶SU Vratio〈0．6，1个病灶SUVratio〉0．6），碘油不均匀沉积并放射性浓聚20个病灶，碘油不均匀沉积并瘤灶放射性分布与邻近正常肝实质相近9个病灶，SUVratio〉0．6。放射性分布缺损或稀疏的8个病灶和SUVratio〈0．6的2个病灶，随访未见复发；其余30个病灶经随访证实复发或残留。^18F-FDGPET／CT显像发现全部肝外病灶。结论：^18F-FDGPET／CT显像可有效监测疗效，并指导进一步治疗。

Clinical value of 18 F-FDG PET/CT to monitor liver cancer after transcatheter arterial chemoembolization with lipiodol

Objective： To investigate the value of is F-FDG PET/CT in liver cancer after transeatheter arterial chemoembolization （TACE） with lipiodol. Methods：22 cases of liver cancer （19M/3F; age 31 - 65） were investigated with 18 F-FDG PET/CT after TACE. The findings of imaging were compared with the results of pathological findings as well as clinical or follow-up data. Results：There were 40 lesions in 22 cases of liver cancer. （1） The lipiodol deposition appearance of CT plain were divided into two types, consisting of those with holo-uniformity dense type in 11 lesions, and nonuniform type 29 lesions; （2） The lesions of 18 F-FDG PET were divided into three types, consisting of those with decreased or absent FDG uptake 8 lesions, increased FDG uptake in 20 lesions, similar FDG uptake to the surrounding nontumor region （SUVratio 〈 0.6 2 lesions, SUVratio 〉 0.6 10 lesions） ; （3） The lesions of is F-FDG PET/CT were divided into four types, consisting of those with holo-uniformity dense and decreased or absent FDG uptake 8 lesions, holo-uniformity dense and similar FDG uptake to the surrounding nontumor region 3 lesions （SUVratio 〈 0.6 2 lesions, SUVratio 〉 0.6 1 lesions）, nonuniform and increased FDG uptake 20 lesions, nonuniform and similar FDG uptake to the surrounding nontumor region 9 lesions（SUVratio 〉 0.6）. Compared with histological findings and clinical follow-up, the lesions with decreased or absent FDG uptake 8 lesions and similar FDG up- take （SUVratio 〈 0.6） 2 lesions were showed no recurrences, whereas the other 30 lesions showed recurrences. The extrahipatie metastases and other tumors were found by PET/CT. Conclusion： lSF-FDG PEF/CT appears to be a valuable method for the assessmem of tumor viability after TACEA for liver cancer, and be a guide in following therapy.