Abstract
Purpose : To reveal the potential of the method of combined PET/CT with 18 F-FDG in the differential diagnosis of space-occupying lesions of the liver. Material and methods : We selected patients for 5 years including PET/CT were detected space-occupying lesions of the liver (1101 patients). All patients underwent a combined PET/CT with 18 F-FDG standard Protocol whole body with the multiphase contrast-enhanced. Indicators of informativeness of MSCT, PET and PET/CT methods (sensitivity, specificity and accuracy) were calculated using standard formulas. Results: Metabolic active liver lesions were revealed in 777 patients. At the same time, despite the predominance of malignant tumors among them (in 99.5 % of patients), we also met metabolic active lesions /foci of FDG hypermetabolism, which belonged not to neoplastic lesions (in 0.5 % of patients). Metabolically inactive liver lesions were detected in 324 patients. Prevailed benign and not neoplastic lesions (in 79.3 % of patients). However, in 20.7 % of patients metabolically inactive liver lesions were malignant (metastatic lesion, metabolically inactive after the conducted chemotherapy in 58 patients, metastases of malignant tumors of the kidney – in 8, high-grade differentiated HCC – in 1). When calculating the indicators of informativeness of MSCT, PET and PET/CT methods, PET was more sensitive (97 %) and more accurate (97 %) than MSCT (93 % and 96 %, thus), MSCT showed higher specificity (98 %) than PET (97 %), but the indicators of informativeness of the PET/CT method were the highest (sensitivity and accuracy reached 98 %, and specificity – 99 %). Conclusion : Based on the results obtained, for the purpose of differential diagnosis of liver lesions, it is recommended to perform PET/ CT with 18 F-FDG with bolus contrast enhancement, because in some cases the liver malignant tumors may be metabolically inactive. PET/ CT has higher rates of informativeness than each of the methods (PET and MSCT) separately, but in some cases, using PET/CT is not always possible to reliably differentiate the malignant and benign lesions (according to our data – 2 %).
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