Title:18 F-FDG PET/MRI of Primary Hepatic Malignancies: Differential Diagnosis
and Histologic Grading
Volume: 20
Author(s): Bedriye Koyuncu Sökmen*Nagihan Inan
Affiliation:
- Department of Radiology, Acıbadem Atakent Hospital, Istanbul, Turkey
Keywords:
Hepatocellular carcinoma, Cholangiocarcinoma, Histopathology, Positron emission tomography, Magnetic resonance imaging, CV.
Abstract:
Background:
Distinguishing between IHCC and HCC is important because of their differences in treatment and prognosis. The hybrid Positron Emission
Tomography/magnetic Resonance Imaging (PET/MRI) system has become more widely accessible, with oncological imaging becoming one of its
most promising applications.
Objective:
The objective of this study was to see how well 18F-fluorodeoxyglucose (18F-FDG) PET/MRI could be used for differential diagnosis and
histologic grading of primary hepatic malignancies.
Methods:
We retrospectively evaluated 64 patients (53 patients with HCC, 11 patients with IHCC) with histologically proven primary hepatic malignancies
using 18F-FDG/MRI. The Apparent Diffusion Coefficient (ADC), Coefficient of Variance (CV) of the ADC, and standardized uptake value (SUV)
were calculated.
Results:
The mean SUVmax value was higher for IHCC (7.7 ± 3.4) than for HCC (5.2 ± 3.1) (p = 0.019). The area under the curve (AUC) was 0.737, an
optimal 6.98 cut-off value providing 72% sensitivity and 79% specificity. The ADCcv value in IHCC was statistically significantly higher than in
HCC (p=0.014). ADC mean values in HCCs were significantly higher in low-grade tumors than in high-grade tumors. The AUC value was 0.73,
and the optimal cut-off point was 1.20x10-6 mm2/s, giving 62% sensitivity and 72% specificity. The SUVmax value was also found to be
statistically significantly higher in the high-grade group. The ADCcv value in the HCC low-grade group was found to be lower than in the highgrade
group (p=0.036).
Conclusion:
18F FDG PET/MRI is a novel imaging technique that can aid in the differentiation of primary hepatic neoplasms as well as tumor-grade
estimation.
