COMBINED POSITRON EMISSION AND COMPUTED TOMOGRAPHY (PET-CT): POTENTIAL OF THE METHOD IN DIFFERENTIAL DIAGNOSIS OF HEPATIC MASSES, AND ALSO IN DETECTION OF THE PRIMARY SITES AT SUSPICION OF METASTATIC MALINGANCIES IN THE LIVER
Keywords:
Сombined positron emission and computed tomography, the tumor of the liver, the differential diagnosis.
Abstract
Aim: to assess the scope and potential of combined PET-CT in differential diagnosis of hepatic masses and in detection of the primary site at suspicion on metastatic malignancies in the liver. Material and Methods. We selected a group of patients (within a 3-year period) in whom hepatic masses were detected by the means of PET-CT (567 patients in total). Of this group, 33 patients did not have the histologically verified diagnosis of cancer. All patients were subjected to combined PET-CT with 18F radiotracer – fluorodeoxyglucose – in accordance with “Whole Body” standard protocol with multiphase contrast study. Results. Metabolically active lesions were identified in 23 patients: in 1 patient – alveococcosis (due to anamnesis), in 22 patients – metastatic lesions. The primary tumor was detected in 9 patients. In the remaining 10 patients metabolically inactive lesions were revealed: in 1 patient, based on MSCT findings, we suspected high-grade differentiated hepatocellular carcinoma (HCC) with metastatic lesions of the liver parenchyma, in 1 patient – differential diagnosis between HCC and hepatocellular adenoma (GTSA) (histologically verified, GTSA), in 4 patients - liver hemangiomas and in 4 patients - the assumption of the benign nature of the process in the absence of metabolic activity, as well as any other foci. Conclusions. So, combined PET-CT should be performed for patients with the purpose of differential diagnosis of the liver lesions. Herewith, the identification of the primary tumor in patients with metastases to the liver is about 40 percent, depending on the histological type of the primary tumor, size of the primary tumor and the plurality of secondary lesions of various organs and systems.References
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6. Zykov E.M., Pozdnyakov A.V., Kostenikov N.A. [Rational Use of PET and PET-CT in Oncology]. Prakticheskaya onkologiya [Practical Oncology], 2014, vol. 15, no. 1, pp. 31–36. (in Russ.)
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11. Sidorenko N.V. [PET in Differential Diagnostics of Focal Liver Formations in Patients with Colorectal Cancer]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 31–32. (in Russ.)
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14. Trufanov G.E., Bagnenko S.S., Rud' S.D. Luchevaya diagnostika zabolevaniy pecheni (Konspekt luchevogo diagnosta) [Radiation Diagnosis of Liver Diseases. Abstract of the Ray Diagnostician]. St. Petersburg, ELBI-SPb Publ., 2011. 418 p.
15. Trufanov G.E., Ryazanov V.V., Fokin V.A. Luchevaya diagnostika zabolevaniy pecheni (MRT, KT, UZI, OFEKT i PET) [Radiation Diagnosis of Liver Diseases (MRI, CT, Ultrasound, SPECT and PET]. Moscow, GEOTAR-Media Publ., 2008. 264 p.
16. Mainenti P.P., Mancini M., Mainolfi C. Detection of Colorectal Liver Metastases. Prospective Comparison of Contrast Enhanced US, Multidetector CT, PET-CT, and 1,5 Tesla MR with Extracellular and Reticulo-Endothelial Cell Specific Contrast Agents. Abdom Imaging, 2010, vol. 35, pp. 511–521. DOI: 10.1007/s00261–009–9555–2
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18. Xu L.H., Cai S.J., Cai G.X. Imaging Diagnosis of Colorectal Liver Metastases. World J Gastroenterol, 2011, nov 14, vol. 17, no. 42, pp. 4654–4659. DOI: 10.3748/wjg.v17.i42.4654
19. Wicherts D.A., de Haas R.J., van Kessel S.C. Incremental Value of Arterial and Equilibrium Phase Compared to Hepatic Venous Phase CT in the Preoperative Staging of Colorectal Liver Metastases. An Evaluation with Different Reference Standards. Eur J Radiol., 2011, vol. 77, pp. 305–311. DOI: 10.1016/j.ejrad.2009.07.026
20. Hekimoglu K., Ustundag Y., Dusak A. Small Colorectal Liver Metastases. Detection with SPIOEnhanced MRI in Comparison with Gadobenate Dimeglumine-Enhanced MRI and CT imaging. Eur J Radiol., 2011, vol. 77, pp. 468–472. DOI: 10.1016/j.ejrad.2009.09.002
2. Zogot S.R., Akberov R.F., Zyyatdinov K.Sh. [Hepatocellular Cancer. Epidemiology, Radiation Diagnosis, Modern Aspects of Treatment]. Prakticheskaya meditsina [Practical Medicine], 2013, no. 2 (67), pp. 112–115. (in Russ.)
3. Danzanova T.Yu., Sinyukova G.T., Lepedatu P.I. [Features of Modern Diagnostics of Metastases of Colorectal Cancer in the Liver]. Onkologicheskaya koloproktologiya [Oncological Coloproctology], 2013, no. 4, pp. 21–28. (in Russ.)
4. Dudarev V.A., Fokin D.V., Dudarev A.A. [The Role of Radiation Methods for the Diagnosis of Focal Lesions of the Liver]. Mezhdunarodnyy zhurnal eksperimental'nogo obrazovaniya [International Journal of Experimental Education], 2015, no. 11 (part 1), pp. 74–76. (in Russ.)
5. Zogot S.R., Akberov R.F., Kim A.B. [Complex Radiation Diagnosis of Liver Echinococcosis]. Prakticheskaya meditsina [Practical Medicine], 2012, no. 3 (58), pp. 75–77. (in Russ.)
6. Zykov E.M., Pozdnyakov A.V., Kostenikov N.A. [Rational Use of PET and PET-CT in Oncology]. Prakticheskaya onkologiya [Practical Oncology], 2014, vol. 15, no. 1, pp. 31–36. (in Russ.)
7. Stepanov S.O., Sedykh S.A., Sidorov D.V. [Radiation Diagnostics and PET in the Evaluation of Focal Liver Damage in Patients with Colorectal Cancer. Review of Literature]. Meditsinskaya vizualizatsiya [Medical Visualization], 2011, no. 4, pp. 68–75. (in Russ.)
8. Puchkov D.D. [Evaluation of the Structural Characteristics of Liver Formations in Patients with Oncological Anamnesis in a Combined PET / CT Study with 18F-FDG]. Rossiyskiy onkologicheskiy zhurnal [Russian Cancer Journal], 2014, no. 4, pp. 41–42. (in Russ.)
9. Tulin P.E., Dolgushin M.B., Patyutko Yu.I. [PET-CT with 18F-FDH and 18F-Choline in the Diagnosis of Mixed Hepatocholangiocellular Carcinoma. Clinical Observation]. Diagnosticheskaya i interventsionnaya radiologiya [Diagnostic and Interventional Radiology], 2015, no. 1, pp. 91–99. (in Russ.)
10. Vit'ko N.K., Zubanov A.G., Radkevich L.A. [The Role of Positron Emission Tomography in Differential Diagnostics of Volumetric Liver Formations]. Kremlevskaya meditsina. Klinicheskiy vestnik [Kremlovskaya Medicine. Clinical Herald], 2011, no. 1, pp. 60–62. (in Russ.)
11. Sidorenko N.V. [PET in Differential Diagnostics of Focal Liver Formations in Patients with Colorectal Cancer]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 31–32. (in Russ.)
12. Sidorenko N.V. [PET in Differential Diagnosis of Focal Liver Formations in Patients with Cirrhosis]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 30–31. (in Russ.)
13. Sidorenko N.V. [The Role of PET with 18F–FDG in the Complex Examination of Patients by Radiation Diagnosis Methods]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search of the XXI Century], 2015, pp. 28–30. (in Russ.)
14. Trufanov G.E., Bagnenko S.S., Rud' S.D. Luchevaya diagnostika zabolevaniy pecheni (Konspekt luchevogo diagnosta) [Radiation Diagnosis of Liver Diseases. Abstract of the Ray Diagnostician]. St. Petersburg, ELBI-SPb Publ., 2011. 418 p.
15. Trufanov G.E., Ryazanov V.V., Fokin V.A. Luchevaya diagnostika zabolevaniy pecheni (MRT, KT, UZI, OFEKT i PET) [Radiation Diagnosis of Liver Diseases (MRI, CT, Ultrasound, SPECT and PET]. Moscow, GEOTAR-Media Publ., 2008. 264 p.
16. Mainenti P.P., Mancini M., Mainolfi C. Detection of Colorectal Liver Metastases. Prospective Comparison of Contrast Enhanced US, Multidetector CT, PET-CT, and 1,5 Tesla MR with Extracellular and Reticulo-Endothelial Cell Specific Contrast Agents. Abdom Imaging, 2010, vol. 35, pp. 511–521. DOI: 10.1007/s00261–009–9555–2
17. Mita K., Kim S.R., Kudo M. Diagnostic Sensitivity of Imaging Modalities for Hepatocellular Carcimoma Smaller Than 2 cm. World J Gastroenterol, 2010, sep 7, vol. 16, no. 33, pp. 4187–4192. DOI: 10.3748/wjg.v16.i33.4187
18. Xu L.H., Cai S.J., Cai G.X. Imaging Diagnosis of Colorectal Liver Metastases. World J Gastroenterol, 2011, nov 14, vol. 17, no. 42, pp. 4654–4659. DOI: 10.3748/wjg.v17.i42.4654
19. Wicherts D.A., de Haas R.J., van Kessel S.C. Incremental Value of Arterial and Equilibrium Phase Compared to Hepatic Venous Phase CT in the Preoperative Staging of Colorectal Liver Metastases. An Evaluation with Different Reference Standards. Eur J Radiol., 2011, vol. 77, pp. 305–311. DOI: 10.1016/j.ejrad.2009.07.026
20. Hekimoglu K., Ustundag Y., Dusak A. Small Colorectal Liver Metastases. Detection with SPIOEnhanced MRI in Comparison with Gadobenate Dimeglumine-Enhanced MRI and CT imaging. Eur J Radiol., 2011, vol. 77, pp. 468–472. DOI: 10.1016/j.ejrad.2009.09.002
2. Zogot S.R., Akberov R.F., Zyyatdinov K.Sh. [Hepatocellular Cancer. Epidemiology, Radiation Diagnosis, Modern Aspects of Treatment]. Prakticheskaya meditsina [Practical Medicine], 2013, no. 2 (67), pp. 112–115. (in Russ.)
3. Danzanova T.Yu., Sinyukova G.T., Lepedatu P.I. [Features of Modern Diagnostics of Metastases of Colorectal Cancer in the Liver]. Onkologicheskaya koloproktologiya [Oncological Coloproctology], 2013, no. 4, pp. 21–28. (in Russ.)
4. Dudarev V.A., Fokin D.V., Dudarev A.A. [The Role of Radiation Methods for the Diagnosis of Focal Lesions of the Liver]. Mezhdunarodnyy zhurnal eksperimental'nogo obrazovaniya [International Journal of Experimental Education], 2015, no. 11 (part 1), pp. 74–76. (in Russ.)
5. Zogot S.R., Akberov R.F., Kim A.B. [Complex Radiation Diagnosis of Liver Echinococcosis]. Prakticheskaya meditsina [Practical Medicine], 2012, no. 3 (58), pp. 75–77. (in Russ.)
6. Zykov E.M., Pozdnyakov A.V., Kostenikov N.A. [Rational Use of PET and PET-CT in Oncology]. Prakticheskaya onkologiya [Practical Oncology], 2014, vol. 15, no. 1, pp. 31–36. (in Russ.)
7. Stepanov S.O., Sedykh S.A., Sidorov D.V. [Radiation Diagnostics and PET in the Evaluation of Focal Liver Damage in Patients with Colorectal Cancer. Review of Literature]. Meditsinskaya vizualizatsiya [Medical Visualization], 2011, no. 4, pp. 68–75. (in Russ.)
8. Puchkov D.D. [Evaluation of the Structural Characteristics of Liver Formations in Patients with Oncological Anamnesis in a Combined PET / CT Study with 18F-FDG]. Rossiyskiy onkologicheskiy zhurnal [Russian Cancer Journal], 2014, no. 4, pp. 41–42. (in Russ.)
9. Tulin P.E., Dolgushin M.B., Patyutko Yu.I. [PET-CT with 18F-FDH and 18F-Choline in the Diagnosis of Mixed Hepatocholangiocellular Carcinoma. Clinical Observation]. Diagnosticheskaya i interventsionnaya radiologiya [Diagnostic and Interventional Radiology], 2015, no. 1, pp. 91–99. (in Russ.)
10. Vit'ko N.K., Zubanov A.G., Radkevich L.A. [The Role of Positron Emission Tomography in Differential Diagnostics of Volumetric Liver Formations]. Kremlevskaya meditsina. Klinicheskiy vestnik [Kremlovskaya Medicine. Clinical Herald], 2011, no. 1, pp. 60–62. (in Russ.)
11. Sidorenko N.V. [PET in Differential Diagnostics of Focal Liver Formations in Patients with Colorectal Cancer]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 31–32. (in Russ.)
12. Sidorenko N.V. [PET in Differential Diagnosis of Focal Liver Formations in Patients with Cirrhosis]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 30–31. (in Russ.)
13. Sidorenko N.V. [The Role of PET with 18F–FDG in the Complex Examination of Patients by Radiation Diagnosis Methods]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search of the XXI Century], 2015, pp. 28–30. (in Russ.)
14. Trufanov G.E., Bagnenko S.S., Rud' S.D. Luchevaya diagnostika zabolevaniy pecheni (Konspekt luchevogo diagnosta) [Radiation Diagnosis of Liver Diseases. Abstract of the Ray Diagnostician]. St. Petersburg, ELBI-SPb Publ., 2011. 418 p.
15. Trufanov G.E., Ryazanov V.V., Fokin V.A. Luchevaya diagnostika zabolevaniy pecheni (MRT, KT, UZI, OFEKT i PET) [Radiation Diagnosis of Liver Diseases (MRI, CT, Ultrasound, SPECT and PET]. Moscow, GEOTAR-Media Publ., 2008. 264 p.
16. Mainenti P.P., Mancini M., Mainolfi C. Detection of Colorectal Liver Metastases. Prospective Comparison of Contrast Enhanced US, Multidetector CT, PET-CT, and 1,5 Tesla MR with Extracellular and Reticulo-Endothelial Cell Specific Contrast Agents. Abdom Imaging, 2010, vol. 35, pp. 511–521. DOI: 10.1007/s00261–009–9555–2
17. Mita K., Kim S.R., Kudo M. Diagnostic Sensitivity of Imaging Modalities for Hepatocellular Carcimoma Smaller Than 2 cm. World J Gastroenterol, 2010, sep 7, vol. 16, no. 33, pp. 4187–4192. DOI: 10.3748/wjg.v16.i33.4187
18. Xu L.H., Cai S.J., Cai G.X. Imaging Diagnosis of Colorectal Liver Metastases. World J Gastroenterol, 2011, nov 14, vol. 17, no. 42, pp. 4654–4659. DOI: 10.3748/wjg.v17.i42.4654
19. Wicherts D.A., de Haas R.J., van Kessel S.C. Incremental Value of Arterial and Equilibrium Phase Compared to Hepatic Venous Phase CT in the Preoperative Staging of Colorectal Liver Metastases. An Evaluation with Different Reference Standards. Eur J Radiol., 2011, vol. 77, pp. 305–311. DOI: 10.1016/j.ejrad.2009.07.026
20. Hekimoglu K., Ustundag Y., Dusak A. Small Colorectal Liver Metastases. Detection with SPIOEnhanced MRI in Comparison with Gadobenate Dimeglumine-Enhanced MRI and CT imaging. Eur J Radiol., 2011, vol. 77, pp. 468–472. DOI: 10.1016/j.ejrad.2009.09.002
References on translit
1. Akberov R.F., Zogot S.R., Kim A.B. [Complex Clinical and Radiation Diagnosis of Cholangiocellular Carcinoma]. Prakticheskaya meditsina [Practical Medicine], 2011, no. 5.1 (48), pp. 121–125. (in Russ.)2. Zogot S.R., Akberov R.F., Zyyatdinov K.Sh. [Hepatocellular Cancer. Epidemiology, Radiation Diagnosis, Modern Aspects of Treatment]. Prakticheskaya meditsina [Practical Medicine], 2013, no. 2 (67), pp. 112–115. (in Russ.)
3. Danzanova T.Yu., Sinyukova G.T., Lepedatu P.I. [Features of Modern Diagnostics of Metastases of Colorectal Cancer in the Liver]. Onkologicheskaya koloproktologiya [Oncological Coloproctology], 2013, no. 4, pp. 21–28. (in Russ.)
4. Dudarev V.A., Fokin D.V., Dudarev A.A. [The Role of Radiation Methods for the Diagnosis of Focal Lesions of the Liver]. Mezhdunarodnyy zhurnal eksperimental'nogo obrazovaniya [International Journal of Experimental Education], 2015, no. 11 (part 1), pp. 74–76. (in Russ.)
5. Zogot S.R., Akberov R.F., Kim A.B. [Complex Radiation Diagnosis of Liver Echinococcosis]. Prakticheskaya meditsina [Practical Medicine], 2012, no. 3 (58), pp. 75–77. (in Russ.)
6. Zykov E.M., Pozdnyakov A.V., Kostenikov N.A. [Rational Use of PET and PET-CT in Oncology]. Prakticheskaya onkologiya [Practical Oncology], 2014, vol. 15, no. 1, pp. 31–36. (in Russ.)
7. Stepanov S.O., Sedykh S.A., Sidorov D.V. [Radiation Diagnostics and PET in the Evaluation of Focal Liver Damage in Patients with Colorectal Cancer. Review of Literature]. Meditsinskaya vizualizatsiya [Medical Visualization], 2011, no. 4, pp. 68–75. (in Russ.)
8. Puchkov D.D. [Evaluation of the Structural Characteristics of Liver Formations in Patients with Oncological Anamnesis in a Combined PET / CT Study with 18F-FDG]. Rossiyskiy onkologicheskiy zhurnal [Russian Cancer Journal], 2014, no. 4, pp. 41–42. (in Russ.)
9. Tulin P.E., Dolgushin M.B., Patyutko Yu.I. [PET-CT with 18F-FDH and 18F-Choline in the Diagnosis of Mixed Hepatocholangiocellular Carcinoma. Clinical Observation]. Diagnosticheskaya i interventsionnaya radiologiya [Diagnostic and Interventional Radiology], 2015, no. 1, pp. 91–99. (in Russ.)
10. Vit'ko N.K., Zubanov A.G., Radkevich L.A. [The Role of Positron Emission Tomography in Differential Diagnostics of Volumetric Liver Formations]. Kremlevskaya meditsina. Klinicheskiy vestnik [Kremlovskaya Medicine. Clinical Herald], 2011, no. 1, pp. 60–62. (in Russ.)
11. Sidorenko N.V. [PET in Differential Diagnostics of Focal Liver Formations in Patients with Colorectal Cancer]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 31–32. (in Russ.)
12. Sidorenko N.V. [PET in Differential Diagnosis of Focal Liver Formations in Patients with Cirrhosis]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search for the 21st Century], 2015, pp. 30–31. (in Russ.)
13. Sidorenko N.V. [The Role of PET with 18F–FDG in the Complex Examination of Patients by Radiation Diagnosis Methods]. Sbornik materialov mezhdunarodnoy nauchnoy konferentsii “Nauchnyy poisk XXI veka” [Collected Materials of the International Scientific Conference Scientific Search of the XXI Century], 2015, pp. 28–30. (in Russ.)
14. Trufanov G.E., Bagnenko S.S., Rud' S.D. Luchevaya diagnostika zabolevaniy pecheni (Konspekt luchevogo diagnosta) [Radiation Diagnosis of Liver Diseases. Abstract of the Ray Diagnostician]. St. Petersburg, ELBI-SPb Publ., 2011. 418 p.
15. Trufanov G.E., Ryazanov V.V., Fokin V.A. Luchevaya diagnostika zabolevaniy pecheni (MRT, KT, UZI, OFEKT i PET) [Radiation Diagnosis of Liver Diseases (MRI, CT, Ultrasound, SPECT and PET]. Moscow, GEOTAR-Media Publ., 2008. 264 p.
16. Mainenti P.P., Mancini M., Mainolfi C. Detection of Colorectal Liver Metastases. Prospective Comparison of Contrast Enhanced US, Multidetector CT, PET-CT, and 1,5 Tesla MR with Extracellular and Reticulo-Endothelial Cell Specific Contrast Agents. Abdom Imaging, 2010, vol. 35, pp. 511–521. DOI: 10.1007/s00261–009–9555–2
17. Mita K., Kim S.R., Kudo M. Diagnostic Sensitivity of Imaging Modalities for Hepatocellular Carcimoma Smaller Than 2 cm. World J Gastroenterol, 2010, sep 7, vol. 16, no. 33, pp. 4187–4192. DOI: 10.3748/wjg.v16.i33.4187
18. Xu L.H., Cai S.J., Cai G.X. Imaging Diagnosis of Colorectal Liver Metastases. World J Gastroenterol, 2011, nov 14, vol. 17, no. 42, pp. 4654–4659. DOI: 10.3748/wjg.v17.i42.4654
19. Wicherts D.A., de Haas R.J., van Kessel S.C. Incremental Value of Arterial and Equilibrium Phase Compared to Hepatic Venous Phase CT in the Preoperative Staging of Colorectal Liver Metastases. An Evaluation with Different Reference Standards. Eur J Radiol., 2011, vol. 77, pp. 305–311. DOI: 10.1016/j.ejrad.2009.07.026
20. Hekimoglu K., Ustundag Y., Dusak A. Small Colorectal Liver Metastases. Detection with SPIOEnhanced MRI in Comparison with Gadobenate Dimeglumine-Enhanced MRI and CT imaging. Eur J Radiol., 2011, vol. 77, pp. 468–472. DOI: 10.1016/j.ejrad.2009.09.002
Published
2017-09-01
How to Cite
Zotova, A., & Afanasyieva, N. (2017). COMBINED POSITRON EMISSION AND COMPUTED TOMOGRAPHY (PET-CT): POTENTIAL OF THE METHOD IN DIFFERENTIAL DIAGNOSIS OF HEPATIC MASSES, AND ALSO IN DETECTION OF THE PRIMARY SITES AT SUSPICION OF METASTATIC MALINGANCIES IN THE LIVER. Human. Sport. Medicine, 17(3), 35-42. https://doi.org/10.14529/hsm170304
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Clinical and Experimental Medicine
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