Clinical application of early PET-CT imaging after radiofrequency ablation of liver neoplasms / 中华放射学杂志

ABSTRACT

Objective To evaluate the application of early 18F-FDG PET-CT imaging after radiofrequency ablation (RFA) of hepatic malignancies. Methods Fifteen patients with liver tumors (five hepatocellular carcinoma, ten colorectal cancer liver metastasis ) underwent RFA as part of clinical management. The lesions were all hypermetabolic on PET-CT performed within 2 weeks prior to RFA. All subjects underwent 18F-FDG PET-CT (early PET-CT) within 24 hours after RFA. Total photopenia, focal uptake, and rim-shaped uptake were regarded as complete ablation, residual tumor, and inflammation, respectively. Follow-up PET-CT scans were performed as the reference standard. Results Twelve patients showed total photopenia at the ablation site on the early PET-CT scan, and in all of these patients, total photopenia at the ablation sites was seen on the follow-up PET-CT scans. Two patients had focal uptake at the ablation sites on the early PET-CT scan, and both of these foci increased in size and intensity, which were compatible with residual tumors at the time of ablation. Only one patient had rim-shaped uptake on the early PET-CT scan. The rim-shaped uptake disappeared on PET-CT performed 3 months later, which indicated the nature of inflammation. Conclusions There is infrequent inflammatory uptake at the RFA site of liver tumors on 18F-FDG PET-CT if scanning is performed within 24 hours after ablation. Thus, early PET-CT has the potential to evaluate the efficacy of an RFA procedure by indicating tumor-free as total photopenia and residual tumors as focal uptake.