Diagnostic Value Of Dual-time Point¹⁸F-FDG PET/CT Imaging In Patients With Hepatocellular Carcinoma

PartⅠ A primary study of the diagnostic value of dual-time point18F-FDG PET/CT imaging in patients with hepatocellular carcinomaObjective:The aim of this study was to evaluate the diagnostic value of dual-time point18F-flurordeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) imaging for hepatocellular carcinoma.Methods:One hundred and fifty patients with clinically suspected hepatic cancer underwent dual-time point18F-FDG PET/CT imaging. The maximum standardized uptake value(SUVmax) was calculated in both time points PET imaging, and the change in SUVmax (Retention Index, RI) was defined as the ratio of the increase in SUVmax between early and delayed scans to the SUVmax in the early scan. The tumor-to-background(T/N) ratio of the early and delayed scan was also calculated. The final diagnoses were confirmed by histopathology. The t-test was used to compare SUVmax, RI and T/N between of benign and malignant groups.Results:There were124patients with hepatocellular carcinoma and26patients with benign lesions. There was significant difference in the SUVmax and T/N between early scan and delayed scan in hepatocellular carcinoma group (t=4.23, p<0.01, t=6.02,P<0.01). There was no significant difference in the SUVmax and T/N between early scan and delayed scan in benign group(t=1.20, p=0.24; t=1.63, p=0.12). There was no significant difference in the RI between hepatocellular carcinoma group and benign group(t=0.52, p=0.60). According to the ROC curve of the early and delayed scan, with the T/N cutoff value of1.41and1.29, the detection rate of the hepatocellular carcinoma was52.4%(65/124) and66.1%(82/124)Conclusions:The present study indicates the dual-time point F-FDG PET/CT imaging is helpful for the detection and diagnosis of hepatocellular carcinoma. PartⅡ Diagnostic value of dual-tune-point18F-FDG PET/CT in patients with hepatocellular carcinoma in different gradeObjective: The aim of this study was to evaluate the usefulness of dual-time-point18F-FDG PET/CT with semiquantitative analyses for patients with hepatocellular carcinoma (HCC) in different grade.Methods：One hundred and twenty-four patients with hepatocellular carcinoma underwent1-h and2-h delay. Dual-time-point PET/CT scan. The maximum standardized uptake value(SUVmax) was calculated in both time points PET imaging， and the change in SUVmax (Retention Index，RI) was defined as the ratio of the increase in SUVmax between early and delayed scans to the SLTVmax in the early scan. The tumor-to-background(T/N) ratio of the early and delayed scan was also calculated. The final diagnoses were confirmed by histopathology. The t-test was used to compare SUVmax，RI and T/N between grade Ⅱ and grade Ⅲ groups.Results：The SUVmax on delayed scan was significantly higher than those on early scan for both groups (t=3．01，p<0.01for grade. Ⅲ group; t=2.93，p<0.01for grade Ⅱ group). Significant differences were detected between grade Ⅲ group and grade Ⅱ group for SUVmax both on early scan and delayed scan(t=2．15，p<0.01for early scan; t=2．11，p<0.01for delayed scan). There was no significant differences between grade Ⅲ group and grade Ⅱ group for retention index of SUVmax (RI-SUVmax）(t=0.06，p=0.95）．The tumor to normal liver tissue (T/N）ratio on delayed scan was significantly higher than those on early scan for both groups (t=4.21， p<0.01for grade Ⅲ group; t=4.44, p<0.01forgrade Ⅱ group). Significant differences were also detected between grade Ⅲ group and grade Ⅱ group for T/N ratio both on early scan and delayed scant;t=2.69, p<0.01for early scan; t=2.06, p<0.01for delayed scan). The SUVmax was positive correlated with the diameter of tumor.Conclusions：Dual-time-point18F-FDG PET/CT with a semiquantitative analyses may have the potential value to diagnostic hepatocellular carcinoma more accurately and was helpful for predicting the histological grades. Part Ⅲ Diagnostic value of dual-time point18F-FDG PET/CT imaging in patients with primary and metastatic liver carcinomaObjective:The aim of this study was to evaluate the diagnostic value of dual-time point18F-FDG PET/CT imaging for primary and metastatic liver carcinoma.Methods:One hundred and seventy-three patients with primary and metastatic liver carcinoma underwent dual-time point18F-FDG PET/CT imaging. The maximum standardized uptake value(SUVmax) was calculated in both time points PET imaging, and the change in SUVmax (Retention Index, RI) was defined as the ratio of the increase in SUVmax between early and delayed scans to the SUVmax in the early scan. The tumor-to-background(T/N) ratio of the early and delayed scan was also been calculated. The final diagnoses were confirmed by histopathology. The t-test was used to compare SUVmax, RI and T/N of hepatocellular^carcinoma, cholangiocarcinoma and liver metastases groups.Results:There were124patients with hepatocellular carcinoma,22patients with cholangiocarcinoma,27patients with liver metastases. There was significant difference in the SUVmax and T/N between early scan and delayed scan in the hepatocellular carcinoma, cholangiocarcinoma and liver metastases groups (p<0.01). There was significant difference in the SUVmax(t=2.67,p=0.01; t=2.88,p<0.01) and T/N ratio (t=3.31,p<0.01; t=3.12, p<0.01) of both early and delayed scan between cholangiocarcinoma and hepatocellular carcinoma group; there was significant difference in the SUVmax of delayed scan (t=2.66, p=0.01) and T/N ratio of both early and delayed scan (t=2.32, p=0.02; t=1.28,p=0.21) between liver metastases and hepatocellular carcinoma group. There was significant difference in the RI between hepatocellular carcinoma group and cholangiocarcinoma group (t=2.24, p=0.03); there was also significant difference in the RI between hepatocellular carcinoma group and liver metastases group (t=2.80,p<0.01).Conclusions:The present study indicates the dual-time point18F-FDG PET/CT imaging is helpful for the differential diagnosis between primary and metastatic liver carcinoma.