ABSTRACT
Objective:To study the efficacy and safety of CT guided percutaneous transhepatic microwave ablation (PTPMWA) for primary liver cancer (PLC) in liver segment 9.Methods:A retrospective study was conducted on PLC patients between October 2013 and March 2019 at Dongguan People’s Hospital, Southern Medical University. Of 41 patients who entered into the study, there were 36 males and 5 females, with an average age of 59.1 years. These patients were diagnosed to have PLC in segment 9. The surgical related data and follow-up results were collected and analyzed.Results:All patients enrolled in the study completed the treatment procedure. CT scan was performed immediately after ablation which showed that the tumor areas to be completely covered by ablation. The duration of operation ranged from 45 to 260 (mean 91) min. The amount of bleeding during treatment was 1.0 to 5.0 (mean 1.4) ml. The complete response rate was 97.6% (40 patients) and the partial response rate was 2.4% (1 patient). The cumulative survival rates at 1, 2, 3, 4 and 5 years were 95.1%, 85.4%, 75.3%, 45.2% and 45.2%, respectively. Only 4 patients (9.8%) developed recurrence after treatment. The timings of recurrence were 1, 6, 13 and 67 months after treatment, respectively. The recurrent lesions were ablated again and complete response was obtained in all patients. There were no serious problems related to complications from ablation. The rate of postoperative complication was 7.3% (3 patients).Conclusion:PTPMWA is a novel treatment for patients with PLC in liver segment 9, the advantages of this treatment include good safety, high efficacy, low complications and local recurrence. The treatment is worthy of further future studies.
ABSTRACT
Objective To analyze the pitfalls of 18F fluorodeoxyglucose (FDG) positron emission tomography/computer tomography (PET-CT) scan in the diagnosis of 60 patients of tuberculosis mimicking malignancy.Methods The study included 60 patients with PET-CT diagnosis of probable malignancy.Fifty patients were proved to be tuberculosis by pathological examinations and 10 were diagnosed by clinical followup.The images of whole body were acquired at 60 min after administration of 222-555 MBq 18F-FDG.The PET-CT imaging characteristics and clinical data,including lesion size,distribution,standardized uptake value (SUV) were retrospectively analyzed.After the whole body scan of PET-CT,each patient had a chest spiral CT scan for detailed observation of lung lesions.Contrast enhanced CT (CECT) was performed in 8 patients.Results (1)Thirty patients were misdiagnosed as lung cancer,14 patients as malignant lymphoma,6 patients as malignant mesothelioma,3 as intestine carcinoma,2 as bone malignancy,1 patient as hepatocarcinoma,spleen malignancy,ovarian cancer,laryngocarcinoma and nasopharyngeal carcinoma respectively.(2) 90.9％ (20/22) of patients showed normal level of serum CEA and 100％ (13/13) of patients showed normal level of CA199.Increasing serum CA125 was found in all patients (6/6) with activeTB patients accompanied with ascites,pleural fluid and (or) pericardial effusion.(3) 93.3％ (28/30)active tuberculosis showed accumulated 18F-FDG which was incorrectly interpreted as malignancy.The most common sites of TB lymphadenopathy were bilateral cervical tissues,which was accounted for 85.7％(12/14).CECT revealed characteristics of peripheral enhancement and central necrosis in tubercular lymphadenopathy,which was 87.5％ (7/8).Conclusions The diverse manifestations of TB on imaging and high uptake of 18F-FDG on PET imaging result in misdiagnosis of malignancy.It is important for radiologists and nuclear medicine physicians to identify the common imaging features and patterns of TB to make a correct diagnosis.Integration of reconstruction HR CT,PET-CT and lab examinations may improve the diagnostic accuracy.