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Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CTand 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation.

Title
 Evaluation of Bone Metastasis from Hepatocellular Carcinoma Using 18F-FDG PET/CTand 99mTc-HDP Bone Scintigraphy: Characteristics of Soft Tissue Formation. 
Authors
 Hyo Jung Seo ; Yun Jung Choi ; Won Jun Kang ; Jong Doo Lee ; Hye Jin Choi ; Mijin Yun ; Jae Hoon Lee ; Arthur Cho ; Yong Hyu Jeong ; Hyun Jeong Kim 
Issue Date
2011
Journal Title
 Nuclear Medicine and Molecular Imaging 
ISSN
 1869-3474 
Citation
 Nuclear Medicine and Molecular Imaging, Vol.45(3) : 203~211, 2011 
Abstract
PURPOSE: Bone metastasis from hepatocellular carcinoma (HCC) can present with soft tissue formation, resulting in oncologic emergency. Contrast-enhanced FDG PET/CT and bone scintigraphy were compared to evaluate characteristics of bone metastases with or without soft tissue formation from HCC. METHODS: Of 4,151 patients with HCC, 263 patients had bone metastases. Eighty-five patients with bone metastasis from HCC underwent contrast-enhanced FDG PET/CT. Fifty-four of the enrolled subjects had recent 99mTc-HDP bone scintigraphy available for comparison. Metastatic bone lesions were identified with visual inspection on FDG PET/CT, and maximum standardized uptake value (SUVmax) was used for the quantitative analysis. Confirmation of bone metastasis was based on histopathology, combined imaging modalities, or serial follow-up studies. RESULTS: Forty-seven patients (55%) presented with soft tissue formation, while the remaining 38 patients presented without soft tissue formation. Frequent sites of bone metastases from HCC were the spine (39%), pelvis (19%), and rib cage (14%). The soft-tissue-formation group had more frequent bone pain (77 vs. 37%, p<0.0001), higher SUVmax (6.02 vs. 3.52, p<0.007), and higher incidence of photon defect in bone scintigraphy (75 vs. 0%) compared to the non-soft-tissue-formation group. FDG PET/CT had higher detection rate for bone metastasis than bone scintigraphy both in lesion-based analysis (98 vs. 53%, p=0.0015) and in patient-based analysis (100 vs. 80%, p<0.001). CONCLUSIONS: Bone metastasis from HCC showed a high incidence of soft tissue formation requiring emergency treatment. Although the characteristic findings for soft tissue formation such as photon defect in bone scintigraphy are helpful in detection, overall detectability of bone metastasis is higher in FDG PET/CT. Contrast-enhanced PET/CT will be useful in finding and delineating soft-tissue-forming bone metastasis from HCC
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/94211
DOI
10.1007/s13139-011-0099-3
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Nuclear Medicine
Yonsei Authors
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