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Conference Paper: Dual-tracer PET/CT for the differential diagnosis of small liver nodules (1-2 cm) in cirrhosis: Early HCC or dysplastic nodule?

TitleDual-tracer PET/CT for the differential diagnosis of small liver nodules (1-2 cm) in cirrhosis: Early HCC or dysplastic nodule?
Authors
Issue Date2012
PublisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
Citation
The Society of Nuclear Medicine (SNM) 2012 Annual Meeting, Miami Beach, Florida, USA, 9-13 June 2012. In The Journal of Nuclear Medicine, 2012, v. 53 n. Suppl. 1, p. abstract no. 566 How to Cite?
Abstract
Objectives: Contrast CT was less accurate in the differentiation of small liver nodules (1-2 cm), particularly in severe cirrhosis. We evaluated the accuracy of dual-tracer (11C-acetate: ACT and 18F-FDG: FDG) PET/CT for the differentiation between small HCC and dysplastic nodules in cirrhotic liver as compared to contrast CT. Methods: Patients with cirrhosis and HCC 1-2 cm confirmed by postoperative pathology after liver transplant or hepatectomy were included if they had both preoperative dual-tracer PET/CT and contrast CT within 1 month. For the diagnosis of HCC, dual-tracer PET/CT was reviewed qualitatively by 3 nuclear medicine physicians in consensus, supported by lesion-to-liver SUV>1.20 (either tracer). Diagnosis by CT was made by 2 radiologists based on the triple-phase pattern of arterial contrast enhancement and washout during portal venous or delayed phase. Each lesion was compared with pathology in terms of diagnosis, size and location. Statistics were analysed by Chi-square and student t tests. Results: 20 patients (M: 15, F: 5, mean: 54±9.2y) with 23 small HCC lesions and 12 dysplastic nodules were identified by postoperative pathology. The mean size of small HCC was 1.6±0.35 cm, dysplastic nodules 1.5±0.34 cm (p>0.05). ACT PET identified 20/23 (87.0%) small HCC lesions while FDG detected 4/23 (17.4%) with dual-tracer sensitivity of 91.3% (21/23). ACT and dual-tracer PET were significantly more sensitive for the diagnosis of early HCC than contrast CT (10/23: 43.5%), with both p<0.05. Of the 23 small HCC lesions, 15 (65.2%) were well and 8 (34.8%) were moderately differentiated. Both FDG and ACT were true negative for all dysplastic nodules (specificity: 100%); while contrast CT misdiagnosed 4 dysplastic nodules as early HCC (specificity: 66.7%). Conclusions: Dual-tracer PET/CT was superior to contrast CT for differentiating small HCC from dysplastic nodules (1-2 cm) in cirrhotic livers. ACT was the PET tracer essential for early HCC detection
DescriptionOncology: Clinical Diagnosis: GI-Colorectal & Liver
Persistent Identifierhttp://hdl.handle.net/10722/165648
ISSN
2013 Impact Factor: 5.563
2013 SCImago Journal Rankings: 2.254

 

DC FieldValueLanguage
dc.contributor.authorHo, CLen_US
dc.contributor.authorChen, SRen_US
dc.contributor.authorCheung, TTen_US
dc.contributor.authorLeung, YLen_US
dc.contributor.authorCheng, TKCen_US
dc.contributor.authorWong, KNen_US
dc.date.accessioned2012-09-20T08:21:40Z-
dc.date.available2012-09-20T08:21:40Z-
dc.date.issued2012en_US
dc.identifier.citationThe Society of Nuclear Medicine (SNM) 2012 Annual Meeting, Miami Beach, Florida, USA, 9-13 June 2012. In The Journal of Nuclear Medicine, 2012, v. 53 n. Suppl. 1, p. abstract no. 566en_US
dc.identifier.issn0161-5505-
dc.identifier.urihttp://hdl.handle.net/10722/165648-
dc.descriptionOncology: Clinical Diagnosis: GI-Colorectal & Liver-
dc.descriptionFulltext in: http://jnumedmtg.snmjournals.org/cgi/content/meeting_abstract/53/1_MeetingAbstracts/566?sid=dcd65c2d-c4f2-479f-b40b-5de796a5fd6d-
dc.description.abstractObjectives: Contrast CT was less accurate in the differentiation of small liver nodules (1-2 cm), particularly in severe cirrhosis. We evaluated the accuracy of dual-tracer (11C-acetate: ACT and 18F-FDG: FDG) PET/CT for the differentiation between small HCC and dysplastic nodules in cirrhotic liver as compared to contrast CT. Methods: Patients with cirrhosis and HCC 1-2 cm confirmed by postoperative pathology after liver transplant or hepatectomy were included if they had both preoperative dual-tracer PET/CT and contrast CT within 1 month. For the diagnosis of HCC, dual-tracer PET/CT was reviewed qualitatively by 3 nuclear medicine physicians in consensus, supported by lesion-to-liver SUV>1.20 (either tracer). Diagnosis by CT was made by 2 radiologists based on the triple-phase pattern of arterial contrast enhancement and washout during portal venous or delayed phase. Each lesion was compared with pathology in terms of diagnosis, size and location. Statistics were analysed by Chi-square and student t tests. Results: 20 patients (M: 15, F: 5, mean: 54±9.2y) with 23 small HCC lesions and 12 dysplastic nodules were identified by postoperative pathology. The mean size of small HCC was 1.6±0.35 cm, dysplastic nodules 1.5±0.34 cm (p>0.05). ACT PET identified 20/23 (87.0%) small HCC lesions while FDG detected 4/23 (17.4%) with dual-tracer sensitivity of 91.3% (21/23). ACT and dual-tracer PET were significantly more sensitive for the diagnosis of early HCC than contrast CT (10/23: 43.5%), with both p<0.05. Of the 23 small HCC lesions, 15 (65.2%) were well and 8 (34.8%) were moderately differentiated. Both FDG and ACT were true negative for all dysplastic nodules (specificity: 100%); while contrast CT misdiagnosed 4 dysplastic nodules as early HCC (specificity: 66.7%). Conclusions: Dual-tracer PET/CT was superior to contrast CT for differentiating small HCC from dysplastic nodules (1-2 cm) in cirrhotic livers. ACT was the PET tracer essential for early HCC detection-
dc.languageengen_US
dc.publisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org-
dc.relation.ispartofThe Journal of Nuclear Medicineen_US
dc.titleDual-tracer PET/CT for the differential diagnosis of small liver nodules (1-2 cm) in cirrhosis: Early HCC or dysplastic nodule?en_US
dc.typeConference_Paperen_US
dc.identifier.emailCheung, TT: cheung68@hku.hken_US
dc.identifier.hkuros211260en_US
dc.identifier.volume53en_US
dc.identifier.issueSuppl. 1en_US
dc.identifier.spageabstract no. 566en_US
dc.identifier.epageabstract no. 566en_US
dc.publisher.placeUnited States-

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