Patient Cao xx, with a history of liver cancer for many years, has a positive attitude and full awareness of his own disease; has carried out multiple interventions, radiofrequency ablation and targeted drug therapy, and recently found that the tumor marker AFP is elevated; the upper abdominal MRI enhancement scan of the outer hospital suspects new lesions in the liver VIII segment; in order to confirm the diagnosis and carry out the next step of treatment, the whole body PET-CT examination in the outer hospital is performed, because the CT examination of the liver image is noisy, and because of the multiple lesions in the liver, it has been repeated many times. The density of lesion areas after multiple treatments is uneven, and the new lesions or post-treatment changes cannot be clearly distinguished, and the uneven distribution of radiation uptake of liver PET images makes it impossible to accurately determine the new small lesions in the liver, which cannot reasonably explain the reasons for the patient's elevated AFP, and directly affects the patient's next treatment direction. In order to clearly determine whether there are new lesions in the liver, the patient underwent a systemic PET-MR examination in our center one week after pet-CT examination in the outer hospital: the examination found that the new small lesions in the LIVER VIII segment were clearly shown to be high signals through the examination; at the same time, the PET-MR high sensitivity PET images also found that the small lesions not detected by PET-CT were highly metabolized; and the lesions of focal glucose metabolism in the lateral margin of the left lobe of the left lobe and the posterior lower part of the liver were found. Combined with clinical analysis, the local tumor activity of the original lesion is still existing.
Through a clear diagnosis, the confusion and doubts of patients and clinicians are greatly solved, so that patients can get timely and effective treatment. At the same time, Director Sun of the Department of Nuclear Medicine personally interpreted the report for the patient, and the patient was very satisfied with the examination.
Comparison of pet-MR and PET-CT diagnostic value of liver tumors:
Systemic PET-MR tests for liver tumors have obvious superiority for the following reasons:
First of all, PET-MR has its inherent equipment advantages: PET-MR has a large axial field of view of PET detector compared with PET-CT, and the detection sensitivity of the device is significantly higher than that of PET-CT; the detection rate of lesions is significantly improved under the same amount of FDG drugs.
Secondly, MR examination has obvious advantages over CT: MR has a higher resolution to soft tissues than CT; at the same time, multi-sequence and multi-parameter imaging (T1WI, T2WI, DWI, etc.) can be performed, especially the sensitivity of DWI sequences in small lesions is significantly increased.
On the basis of MRI multimodal imaging, the FDG metabolism of the lesion can be combined, and the advantages of the equipment can be fully utilized to customize the tumor personalized scanning program, which greatly improves the detection rate of lesions.
Author | Wu Xizhen
Source | Beijing is a vein of sunshine