Kontrastlı BT'nin Karaciğer Lezyonlarının Karakterizasyonunda FDG PET'e Katkısı ve Kantitatif Etkileri

Mutlay Keski̇n, Şeyda Türkölmez, Elif Özdemir, Nilüfer Yildirim, Zuhal Kandemi̇r
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Abstract

Background: The goals of this study was to evaluate the diagnostic capability of enhanced/unenhanced 18F-FDG-PET/CT scans for identifying primary-secondary liver malignancies in terms of size and localization, to decide the quantitative impact of contrast agent on the SUVmax values of liver lesions and normal liver tissue, and to assess the impact in SUVmax metrics following contrast substance administration. Materials and Methods: This was a prospective research that included patients with suspicious primary and secondary hepatic cancers. Patients had non-enhanced & enhanced regional PET/CT examinations. The dimen-sion, position, densities (HU), visually assessment outcome, and SUVmax values for all pathological lesions were recorded, as well as the HU and SUVmax data of normal hepatic tissue. Results: There were 97 liver lesions in total. Visually assessment outcome of lesions, the introduction of a contrast substance considerably enhanced the HU and SUVmax measurements for normal hepatic tissue. The HU measurements for lesions bigger than 1cm increased statistically significantly, as did the SUVmax levels of centralized lesions bigger than 1cm. The attenuation adjustment procedures, resulted in an average inaccuracy in computed SUVmax values at the ratio of %5 for normal liver tissue and %6 for all hepatic pathologies follow-ing the contrast substance delivery. Conclusions: The inclusion of contrast substance increases the identification, localization, and characterization of the liver lesions with PET/CT substantially.
对比增强 CT 和 FDG PET 在描述肝脏病变中的贡献和定量效果
研究背景本研究的目的是评估增强/未增强 18F-FDG-PET/CT 扫描在大小和定位方面识别原发性-继发性肝脏恶性肿瘤的诊断能力,确定造影剂对肝脏病变和正常肝组织 SUVmax 值的定量影响,并评估使用造影剂后对 SUVmax 指标的影响。材料与方法:这是一项前瞻性研究,包括可疑的原发性和继发性肝癌患者。患者接受非增强和增强区域 PET/CT 检查。记录所有病变的大小、位置、密度(HU)、视觉评估结果和 SUVmax 值,以及正常肝组织的 HU 和 SUVmax 数据。结果肝脏病变共 97 例。对病变的视觉评估结果显示,造影剂的引入大大提高了正常肝组织的 HU 值和 SUVmax 值。大于 1 厘米的病变的 HU 测量值明显增加,大于 1 厘米的中心病变的 SUVmax 水平也明显增加。衰减调整程序导致计算出的 SUVmax 值的平均误差率为:正常肝组织为 5%,所有肝脏病变为 6%。结论:造影剂的加入大大提高了 PET/CT 对肝脏病变的识别、定位和定性。
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