目的探讨18氟-脱氧葡萄糖(18 F-fluorodexyoxyglucose,18F-FDG)和11碳-乙酸(11 C-acetate,11 C-ACT)PET/CT显像在原发性肝癌及肝脏肿瘤样病变诊断中的作用。方法回顾性分析9例患者资料,其中男性7例,女性2例,平均年龄70.2岁,所有患者均为肝内单发病灶。治疗前均先行18 F-FDG PET/CT,后行11 C-ACT PET/CT检查,两次检查间隔时间不超过1周。其中有7例肝细胞肝癌(hepatocelluar carcinoma,HCC)、1例胆管细胞癌(cholangiocarcinoma,CCC)、1例肝内感染性病灶,均经病理学或临床随访证实。结果 7例HCC患者18 F-FDG PET/CT显像均为阴性,11 C-ACT PET/CT显像有6例为阳性。18F-FDG PET/CT和11 C-ACT PET/CT显像均未发现1例高分化胆管细胞癌。对于1例肝内炎性病灶,18F-FDG PET/CT显像为阳性,而11 C-ACT PET/CT显像为阴性。结论①11 C-ACT PET/CT显像可以用来探测那些呈18 F-FDG等或低摄取的HCC病灶;②对于高分化的CCC,18 F-FDG PET/CT显像有可能会表现为假阴性结果;③11 C-ACT PET/CT显像可以用来诊断肝内感染性病灶。
Objective This preliminary study was designed to investigate the performance of positron emission tomography/ computer tomography(PET/CT) scanning for primary liver tumors and tumor-like diseases using 18F-fluorodexyoxyglucose(18F-FDG) and 11C-acetate(11C-ACT).Methods Nine patients(M:F=7:2,with mean age of 70.2),each of whom had one lesion only,were selected for this retrospective study.All patients had undergone a "dual-tracer" PET/CT scanning with 11C-ACT followed by 18F-FDG before treatment.The interval of two imaging was no more than one week.Verified by histopathology or clinical follow-up,there were 7 hepatocelluar carcinomas(HCCs),1 cholangiocarcinoma(CCC) and 1 infecting-lesion.Both PET/CT images were interpreted by two experienced nuclear physicians,based on visual assessment or semiquantitative analysis.Results 18F-FDG PET/CT showed equal or low uptake in 7 HCCs,and 11C-ACT PET/CT showed high uptake in 6 of them.Either 18F-FDG or 11C-ACT PET/CT scanning did not detect the well-differentiated CCC.The infecting-lesion showed high uptake in 18F-FDG PET/CT imaging,but equal in 11C-ACT PET/CT imaging.Conclusion ①11C-ACT PET/CT scanning would be used to detect HCCs,which showed equal or low uptake in 18F-FDG;②18F-FDG PET/CT scanning,might show a false-negative in detecting the well-differentiated CCC;③11C-ACT PET/CT scanning might be used to diagnose the infecting-lesions in liver.