Multiparametric FDG-PET/MRI of Hepatocellular Carcinoma: Initial Experience
Résumé
Purpose. 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 diiusion-weighted imaging (IVIM-DWI), and dynamic contrast-enhanced-(DCE-) MRI was performed simultaneously with 18 F-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 (SUV mean and SUV max) were quantiied and compared between HCC lesions and liver parenchyma using Wilcoxon signed-rank tests. SUV ratios between HCCs and liver were also calculated (SUV mean T/L and SUV max T/L). Diagnostic performance of (combined) mp-PET/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 signiicantly higher arterial fraction (from DCE-MRI) and lower R * 2 pre-O 2 and post-O 2 (from BOLD-MRI) versus liver parenchyma (P < 0.032). e highest diagnostic performance for diierentiation between HCC and liver parenchyma was achieved for combined ART SSM and R * 2 post-O 2 (AUC 0.91). SUV max showed reasonable performance for diierentiation of HCC versus liver (AUC 0.75). In HCC, DCE-MRI parameters K trans (TM and SSM) and v e TM exhibited signiicant negative correlations with SUV max 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 SUV max for HCC detection and several signiicant 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.
Domaines
Imagerie médicaleOrigine | Publication financée par une institution |
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