Assessment of disease activity in alveolar echinococcosis: a comparison of contrast enhanced ultrasound, three-phase helical CT and [(18)F] fluorodeoxyglucose positron emission tomography.
BACKGROUND
Objective of the present study was to assess activity or vascularization of focal liver lesions in alveolar echinococcosis (AE) using [18F]fluorodeoxyglucose positron emission tomography (FDG-PET) in comparison with contrast enhanced ultrasound (CEUS) and three-phase helical computed tomography (CT).


METHODS
In this prospective study, 17 patients with confirmed AE of the liver were included (6 males, 11 females; average age: 59 +/- 16 years; average duration of disease: 10.5 years) and were then examined using FDG-PET, precontrast ultrasound (US), CEUS, and three-phase helical CT. We assessed metabolic activity (FDG-PET) and vascularization (CEUS and CT) of Echinococcus multilocularis specific hepatic lesions.


RESULTS
FDG-PET identified increased metabolic activity in the corresponding lesions in seven patients (41.2%). A vascularization pattern of echinococcal lesions was visualized in 9 patients (52.9%) by CEUS and in 4 patients (23.5%) by CT. All positive FDG-PET findings were also positive at CEUS.


CONCLUSIONS
There was association between findings of metabolic activity in AE at FDG-PET and vascularized lesions of the liver returned by CEUS. This suggests that CEUS may represent a cost-effective tool in the decision making to perform FDG-PET examination.
Ehrhardt
Alexander R
AR
Department of Internal Medicine I, University Hospital Ulm, Robert-Koch-Str. 8, 89081, Ulm, Germany. wolfgang.kratzer@uniklinik-ulm.de
Reuter
Stefan
S
Buck
Andreas K
AK
Haenle
Mark M
MM
Mason
Richard A
RA
Gabelmann
Andreas
A
Kern
Peter
P
Kratzer
Wolfgang
W
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D004443:Echinococcosis; D004444:Echinococcosis, Hepatic / Q000000981:diagnostic imaging*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010743:Phospholipids; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D013459:Sulfur Hexafluoride; D036542:Tomography, Spiral Computed / Q000379:methods*; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; D019275:Radiopharmaceuticals; C420843:contrast agent BR1; D019788:Fluorodeoxyglucose F18; D007472:Iohexol; C038192:iopromide; D013459:Sulfur Hexafluoride