Authors: Jacomina W van den Esschert Matthanja Bieze Ulrich H Beuers Thomas M van Gulik Roelof J Bennink
Publish Date: 2010/08/18
Volume: 38, Issue: 3, Pages: 436-440
Abstract
The aim of this pilot study was to evaluate the use of PET/CT with 18Ffluorocholine in the differentiation of hepatocellular adenoma HCA from focal nodular hyperplasia FNH Patients with liver lesions larger than 2 cm suspicious for HCA or FNH were prospectively included All patients underwent PET/CT with 18Ffluorocholine and histopathological diagnosis was obtained by either liver biopsy or surgery The ratios between the maximum standardized uptake value SUV of the lesion and the mean SUV of normal liver parenchyma were calculated and a receiver operating characteristic ROC curve analysis was performed Ten patients with FNH and 11 with HCA were included The mean SUV ratio was 168±029 ±SD for FNH and 088±018 for HCA p0001 An SUV ratio cutoff value between 112 and 122 differentiated patients with FNH from those with HCA with 100 sensitivity and 100 specificity This pilot study showed that PET/CT with 18Ffluorocholine can differentiate HCA from FNHHepatocellular adenoma HCA and focal nodular hyperplasia FNH are benign hypervascular liver lesions that predominantly occur in young and middleaged women Differentiation of these two tumours using radiological imaging modalities may be difficult because of radiological features shared by both tumours 1 The frequency with which the diagnosis is in question after routine radiological examination is unclear Recently it has been reported that MRI with a hepatospecific contrast agent distinguishes HCA from FNH with a sensitivity and specificity of 969 and 100 respectively However the diagnosis of most of these lesions was based solely on imaging results without histological confirmation 2 Differentiation is crucial to decide on appropriate management because of the different therapeutic consequences FNH is a strictly benign liver lesion and complications are very rare Conservative treatment is therefore justified in the absence of mechanical symptoms On the other hand HCA carries a risk of spontaneous bleeding 3 and malignant transformation especially when the lesion is larger than 5 cm 4 Therefore resection of a HCA larger than 5 cm is usually advocated
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