A new classification of hepatic alveolar echinococcosis (HAE) calcification and biological activity using CT and PET-CT

Sanawar Abbas Ailixire,Kurelli Sai Charan Goud,Kanduri Hari Krishna,Liu Wenya

doi:10.1016/j.jrid.2019.06.002

Abstract

ObjectivesThe aim of this study is to establish a pattern of calcification and biological activity in hepatic alveolar echinococcosis (HAE) using CT and PET-CT. Material and methodA Retrospective study is conducted on 60 patients in the First Affiliated Hospital of Xinjiang Medical University from June 2016 to April 2017 with confirmed diagnosis of hepatic alveolar echinococcosis or with confirmed diagnosis of surgical pathology of HAE. All patients underwent abdominal CT scan and double-phase enhanced PET-CT examination was confirmed with a single lesion. The CT and PET-CT features were analyzed, and the maximum standard uptake value (SUVmax) of the focal lesion on the PET-CT was measured. According to the calcification, HAE patients were classified into I, II, III categories. Kruskal–Wallis H test was used to compare the difference of SUVmax between lesions of different HAE types. ResultSixty patients with hepatic alveolar echinococcosis were evenly divided into I, II and III categories by different calcifications patterns in CT and biological activity on PET-CT. The median SUVmax of I, II and III were 3.41 (2.17–3.75), 7.45 (6.77–9.01) and 6.67 (6.28–9.01), respectively. The median SUVmax within three types was statistically significant (χ2 = 4.429, P < 0.05). DiscussionThe combination of Computed tomography (CT), with 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET), warrants one of the most reliable diagnostic imaging modalities for early diagnosing and monitoring the characteristic calcifications and biological activity in the course of the disease (alveolar echinococcosis). The biological activity of different calcifications pattern of HAE is different. ConclusionThis study is intended to help further differentiate the recognition and interpretation of hepatic lesions based on their calcification pattern and biological activity, and make a ground for future studies.

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