مرکز منطقه ای اطلاع رساني علوم و فناوري - Multiparametric FDG-PET/MRI of Hepatocellular Carcinoma: Initial Experience

Author/Authors :

Hectors, Stefanie J Icahn School of Medicine at Mount Sinai - 1 Gustave L Levy Place - New York, USA , Wagner, Mathilde Icahn School of Medicine at Mount Sinai - 1 Gustave L Levy Place - New York, USA , Besa, Cecilia Icahn School of Medicine at Mount Sinai - 1 Gustave L Levy Place - New York, USA , Huang, Wei Oregon Health & Science University - Portland, USA , Taouli, Bachir Icahn School of Medicine at Mount Sinai - 1 Gustave L Levy Place - New York, USA

Abstract :

To compare multiparametric (mp)FDG-PET/MRI metrics between hepatocellular carcinoma (HCC) and liver parenchyma and to assess the correlation between mpMRI and FDG-PET standard uptake values (SUVs) in liver parenchyma and HCC. Methods. is prospective, institutional review board-approved study enrolled 15 patients (M/F 12/3; mean age 61 y) with HCC. mpMRI including blood-oxygen-level-dependent (BOLD) MRI, intravoxel incoherent motion difiusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced-(DCE-) MRI was performed simultaneously with 18F-FDG-PET on a 3T PET/MRI hybrid system. Quantitative BOLD, IVIM and DCE-MRI parameters (Tofts model (TM) and shutter-speed model (SSM)), and PET parameters (SUVmean and SUVmax) were quantified and compared between HCC lesions and liver parenchyma using Wilcoxon signed-rank tests. SUV ratios between HCCs and liver were also calculated (SUVmean T/L and SUVmax T/L). Diagnostic performance of (combined) mpPET/MRI parameters for characterization of HCC was assessed using ROC analysis. Spearman correlations between PET and mpMRI parameters in HCC tumors and liver parenchyma were evaluated. Results. 21 HCC lesions (mean size 4.0±2.4 cm; range 2–13 cm) were analyzed. HCCs exhibited significantly higher arterial fraction (from DCE-MRI) and lower R= 2 pre-O2 and post-O2 (from BOLD-MRI) versus liver parenchyma (P < 0.032). e highest diagnostic performance for difierentiation between HCC and liver parenchyma was achieved for combined ART SSM and R∗ 2 post-O2 (AUC= 0.91). SUVmax showed reasonable performance for difierentiation of HCC versus liver (AUC= 0.75). In HCC, DCE-MRI parameters Ktrans (TM and SSM) and ve TM exhibited significant negative correlations with SUVmax T/L (r ranges from −0.624 to −0.566; FDR-adjusted P < 0.050). Conclusions. Despite the observed reasonable diagnostic performance of FDG-PET SUVmax for HCC detection and several significant correlations between FDG-PET SUV and DCE-MRI parameters, FDG-PET did not provide clear additional value for HCC characterization compared to mpMRI in this pilot study.