Comparison of 18F-FDG PET/CT and contrast enhanced ultrasound for detection of hepatocellular carcinoma recurrence after therapy / 中华核医学与分子影像杂志

ABSTRACT

Objective To compare the efficiency of 18F-FDG PET/CT and contrast enhanced ultrasound (CEUS) in detection of HCC recurrence after surgery or radiofrequency ablation (RFA).Methods Twenty-seven HCC patients (22 males,5 females; average age47 years) were included in this study,of which 15 patients underwent surgery and 12 patients underwent RFA therapy.18F-FDG PET/CT and CEUS were performed within 2 weeks in all patients to detect recurrence.Final diagnosis was made by pathology or clinical follow-up (＞6 months),and the sensitivity,specificity and accuracy of 18F-FDG PET/CT and CEUS were calculated and compared.McNemar test was used for data analysis.Results Twenty-five patients were diagnosed with HCC recurrence,including 11 cases with extrahepatic metastases.Another 2 patients had extrahepatic metastases without HCC recurrences.The sensitivity,specificity and accuracy in detection of liver lesion with 18F-FDG PET/CT were 92.0％ (23/25),2/2 and 92.6％ (25/27),respectively.While with CEUS,the corresponding values were 60.0％ (15/25),2/2 and 63.0％ (17/27),respectively.In CEUS positive group,the sensitivity and accuracy were 100％(15/15) for both methods.In CEUS negative group,the sensitivity,specificity and accuracy of 18 F-FDG PET/CT in detection of liver lesion were 8/10,2/2 and 83.3％(10/12),respectively.The sensitivity and accuracy of 18F-FDG PET/CT were significantly higher than those of CEUS (0,16.7％(2/12) ; x2 =5.373,5.250,both P＜0.05).Moreover,the sensitivity of 18 F-FDG PET/CT in detecting extrahepatic metastasis was 100％ (13/13).Conclusions 18 F-FDG PET/CT is more sensitive and accurate than CEUS (especially in CEUS negative cases) in detecting recurrence of HCC after surgery or RFA.18F-FDG PET/CT also could be useful for detection of extrahepatic metastasis.