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Usefulness of 18F-FDG PET/CT and Multiphase CT in the Differential Diagnosis of Hepatocellular Carcinoma and Combined Hepatocellular Carcinoma-Cholangiocarcinoma

대한영상의학회지 2020년 81권 6호 p.1424 ~ 1435
박재춘, 박정구, 정규식, 강희, 전성민,
소속 상세정보
박재춘 ( Park Jae-Chun ) - Kosin University College of Medicine Kosin University Gospel Hospital Department of Radiology
박정구 ( Park Jung-Gu ) - Kosin University College of Medicine Kosin University Gospel Hospital Department of Radiology
정규식 ( Jung Gyoo-Sik ) - Kosin University College of Medicine Kosin University Gospel Hospital Department of Radiology
강희 ( Kang Hee ) - Kosin University College of Medicine Kosin University Gospel Hospital Department of Radiology
전성민 ( Jun Sung-Min ) - Kosin University College of Medicine Kosin University Gospel Hospital Department of Nuclear Medicine

Abstract


Purpose: The purpose of this study was to evaluate the usefulness of multiphasic CT and 18F-fluorodeoxyglucose (FDG) PET/CT for the differentiation of combined hepatocellular carcinomacholangiocarcinoma (cHCC-CCA) from hepatocellular carcinoma (HCC).

Materials and Methods: From January 2007 to April 2016, 93 patients with pathologically confirmed HCC (n = 84) or cHCC-CCA (n = 9) underwent CT and PET/CT imaging. Contrast enhancement patterns were divided into three types based on the attenuation of the surrounding liver parenchyma: type I (early arterial enhancement with delayed washout), type II (early arterial enhancement without delayed washout), and type III (early hypovascular, infiltrative appearance, or peripheral rim enhancement).

Results: cHCC-CCAs (89%) had a higher PET/CT positive rate than did HCCs (61%), but the PET/CT positive rate did not differ significantly (p = 0.095). Among the 19 cases of the type II enhancement pattern, 3 (21%) of 14 HCCs and 4 (80%) of 5 cHCC-CCAs were PET/CT positive. cHCC-CCAs had a significantly higher PET/CT positive rate (p = 0.020) in the type II enhancement pattern.

Conclusion: The PET/CT positive rate of cHCC-CCA was significantly higher than that of HCC in lesions with a type II enhancement pattern. The 18F-FDG PET/CT can be useful for the differentiation of cHCC-CCA from HCC in lesions with a type II enhancement pattern on multiphasic CT.

키워드

Carcinoma, Hepatocellular; Positron Emission Tomography Computed Tomography; Tomography, X-Ray Computed

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