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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?
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TitleDual-tracer PET/CT for the differential diagnosis of small liver nodules (1-2 cm) in cirrhosis: Early HCC or dysplastic nodule?
 
AuthorsHo, CL
Chen, SR
Cheung, TT
Leung, YL
Cheng, TKC
Wong, KN
 
Issue Date2012
 
PublisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
 
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. 566 [How to Cite?]
 
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
 
DescriptionOncology: Clinical Diagnosis: GI-Colorectal & Liver
Fulltext in: http://jnumedmtg.snmjournals.org/cgi/content/meeting_abstract/53/1_MeetingAbstracts/566?sid=dcd65c2d-c4f2-479f-b40b-5de796a5fd6d
 
ISSN0161-5505
2013 Impact Factor: 5.563
2013 SCImago Journal Rankings: 2.254
 
DC FieldValue
dc.contributor.authorHo, CL
 
dc.contributor.authorChen, SR
 
dc.contributor.authorCheung, TT
 
dc.contributor.authorLeung, YL
 
dc.contributor.authorCheng, TKC
 
dc.contributor.authorWong, KN
 
dc.date.accessioned2012-09-20T08:21:40Z
 
dc.date.available2012-09-20T08:21:40Z
 
dc.date.issued2012
 
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.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.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. 566 [How to Cite?]
 
dc.identifier.epageabstract no. 566
 
dc.identifier.hkuros211260
 
dc.identifier.issn0161-5505
2013 Impact Factor: 5.563
2013 SCImago Journal Rankings: 2.254
 
dc.identifier.issueSuppl. 1
 
dc.identifier.spageabstract no. 566
 
dc.identifier.urihttp://hdl.handle.net/10722/165648
 
dc.identifier.volume53
 
dc.languageeng
 
dc.publisherSociety of Nuclear Medicine. The Journal's web site is located at http://jnm.snmjournals.org
 
dc.publisher.placeUnited States
 
dc.relation.ispartofThe Journal of Nuclear Medicine
 
dc.titleDual-tracer PET/CT for the differential diagnosis of small liver nodules (1-2 cm) in cirrhosis: Early HCC or dysplastic nodule?
 
dc.typeConference_Paper
 
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<item><contributor.author>Ho, CL</contributor.author>
<contributor.author>Chen, SR</contributor.author>
<contributor.author>Cheung, TT</contributor.author>
<contributor.author>Leung, YL</contributor.author>
<contributor.author>Cheng, TKC</contributor.author>
<contributor.author>Wong, KN</contributor.author>
<date.accessioned>2012-09-20T08:21:40Z</date.accessioned>
<date.available>2012-09-20T08:21:40Z</date.available>
<date.issued>2012</date.issued>
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<description>Oncology: Clinical Diagnosis: GI-Colorectal &amp; Liver</description>
<description>Fulltext in: http://jnumedmtg.snmjournals.org/cgi/content/meeting_abstract/53/1_MeetingAbstracts/566?sid=dcd65c2d-c4f2-479f-b40b-5de796a5fd6d</description>
<description.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&gt;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&#177;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&#177;0.35 cm, dysplastic nodules 1.5&#177;0.34 cm (p&gt;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&lt;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</description.abstract>
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