Application of Dual-tracer Positron Emission Tomography in the Pre-operative Diagnosis of Liver Masses

  Objective  To evaluate the value of the dual-tracer positron emission tomography(PET)in the pre-operative diagnosis of liver masses.

  Methods  Totally 40 patients whose liver masses could not be positioned by routine examination were enrolled in this study from October 2004 to August 2010.All patients received PET examination using ¹⁸F-fluorodeoxyglucose(¹⁸F-FDG)and ¹¹C-Acetate as tracer.

  Results  Of these 40 patients, the masses were pathologically confirmed to be malignant in 33 patients, precancerous changes in 2 patients, and benign in 5 patients.On the contrary, dual-tracer PET found malignant lesions in 34 patients, with a sensitivity of 97.1% and a positive predictive value of 91.9%.¹⁸F-FDG PET identified 20 malignant masses(57.1%)and ¹¹C-Acetate PET identified 29(82.9%).For atypical hyperplasia, well differentiated lesions, and moderately well-differentiated lesions, the sensitivity of ¹¹C-acetate(100%)was significantly higher than ¹⁸F-FDG(28.6%)(P < 0.01).However, for poorly differentiated lesions and moderately poor-differentiated lesions, the sensitivity of ¹⁸F-FDG was a bit higher but without statistical significance.

  Conclusion  The combined application of these two tracers in PET can increase the diagnostic accuracy for liver masses preoperatively and may indicate the differentiation levels of tumors, and thus provides useful information for surgical decision-making.