肝移植 , 肝癌 , PET/CT , 代谢参数

Objective To explore the value of 18 F-FDG PET/CT in preoperative evaluation by analyzing the clinical characteristics and PET/CT metabolic parameters of liver transplantation patients with liver cancer. Methods A retrospective study from October 2014 to May 2017 was carried out, a total number of 92 patientswith liver cancer who received liver transplantation and had PET/CT examination pre and post operation in Tianjin First Central Hospital were enrolled. Metabolic parameters were measured or calculated using TrueD software including the maximum standardized uptake value（SUVmax）of normal liver parenchyma，liver cancer lesions and mediastinum，SUV normalized to lean body mass（SUL），tumor metabolic volume（MTV），tumor-to-mediastinum SUV ratio（TMR），tumor-tonormal liver SUV ratio（TLR）and total lesion glycolysis（TLG）. The correlation between metabolic parameters and clinical characteristics and their value in predicting pathological indicators were analyzed by one-way analysis of variance（ANOVA）， and the correlation between metabolic parameters was analyzed to calculate the Pearson correlation coefficient. Results A total number of 90 patients had a history of hepatitis，including 83 cases of hepatitis B，5 cases of hepatitis C， 1 case of hepatitis B and D，and 1 case of autoimmune hepatitis. The high，medium and low pathological differentiation cases were 28，36 and 22，respectively. Two cases with unclear differentiation and 4 cases had no tumor. There were 90 cases of negative stump or incisal edge of vena cava，portal vein and biliary system，and 2 cases were positive. A total number of 64 cases were negative for satellite nodules and 28 cases were positive. 51 cases were negative of microvascular invasion（MVI）and 41 cases were positive. A total number of 60 patients were negative of detected portal vein and interstitial vascular tumor embolus and 32 cases were positive. The correlation coefficient between the SUVmax of liver background and mediastinum background（LBmax，Mmax）was 0.867，and LBmax was higher than Mmax. The correlation coefficient between SUVmax and SUL was 0.985 and the correlation coefficient between TLR and TMR was 0.986. There was no difference between the metabolic parameters of different TNM stages. There was no significant difference between the metabolic parameters of hepatocellular carcinoma group and cholangiocarcinoma group，no difference was observed in moderately and poorly differentiated groups. There was no difference in the metabolic parameters when considering the tumor number，tumor site，cirrhosis，hepatitis type and activity，cancer thrombus，AFP level，negativity of stump or incisal edge of vena cava，portal vein and biliary，negativity of detected portal vein and interstitial vascular tumor embolus. There were significant differences in SUVmax，TMR，TLR，SUL，MTV and TLG between lymph node metastasis group and non-metastasis group（P ＜ 0.05）. There were significant differences in SUVmax，TMR，TLR and SUL and no significant differences in MTV and TLG between satellite nodules negative and positive groups（P ＜ 0.05）. There were significant differences in TMR，TLR，SUL and TLG between MVI negative and positive groups（P ＜ 0.05），and there was no significant difference in SUVmax and MTV between the two groups. Conclusion 18 F-FDG PET/CT can evaluate the tumor distribution and stage accurately and comprehensively，identify the degree of tumor differentiation，predict MVI，and so as to predict the prognosis of liver transplantation patients

Liver transplantation, Hepatocellular carcinoma, PET/CT, Metabolic parameters