PETCT在肝肿瘤诊治中应用2.pptVIP

诊断与预后评价 分期与再分期 疗效评价 在肝肿瘤诊治中的应用 18F-FDG PET/CT与疗效评价 治疗后病灶代谢改变早于形态改变；鉴别肿瘤残存复发与纤维瘢痕组织。 射频治疗后24h，病灶糖代谢模式对于预测局部疾病进展（8-10w）：无增高（37%）、环形增高（29%）、结节状增高（63%）；结节状代谢增高具有最高的特异性（95%）。 Gerald Antoch, MD1; Florian M. Vogt, MD1; Patrick Veit, MD，et al. Assessment of Liver Tissue After Radiofrequency Ablation: Findings with Different Imaging Procedures. J Nucl Med 2005 PET/CT显像的特点 代谢显像与功能显像 全身、断层影像 多模式的影像诊断 安全、无创 * Various F-18-FDG uptake patterns in HCCs. The F-18-FDG uptake pattern is well correlated with histopathologic grading in HCCs. (A) F-18-FDG uptake is intensely increased in high-grade HCC and (B) moderately increased in intermediate HCCs or mixed high- and low-grade HCC cells (arrows). (C) Uptake is not significantly increased in low-grade HCCs. * FCH (a) and FDG (b) PET/CT images of patient no. 12, with diffuse recurrence of HCC involving all the liver.FCH PET/CT reveals several foci in the liver (i), whereas the liver recurrence is not visible on FDG PET/CT (ii). Bone foci corresponding to lytic lesions in several thoracic vertebrae and ribs (iii) show much more intense uptake on FCH than on FDG PET/CT * Intrahepatic mass-forming cholangiocarcinoma. (A) Arterial phase CT demonstrates a large low-density mass in the medial segment (arrow). (B) F-18-FDG PET shows hypermetabolic mass with central hypometabolic core (arrow). (C) T2-weighted MR imaging shows hyperintense viable tumor with central hypointense fibrotic area (arrow). * Fig.15. Hilar periductal-infiltrating cholangiocarcinoma. (A) MR cholangiopancreatography demonstrates obliteration of the hilar bile ducts (arrows). (B) F-18-FDG PET coronal image shows nodular lesions along the bile duct with mild hypermetabolism (arrow). (C) Contrast-enhanced CT shows concentric narrowing and wall thickening with contrast enhancement along the bile duct (arrow). (D) F-18-FDG PET axial image shows mild FDG uptake in the corresponding lesion (arrow). * Fig.16. False-negative F-18-FDG PET-CT in a mixed periductal-infi