title: Diagnostic value of 18F-FDG-PET/CT in indeterminate infiltrative hepatic lesions in an endemic area of viral hepatitis.
abstract: OBJECTIVE
  Infiltrative hepatic lesions in conventional imaging modalities are a continuing diagnostic challenge in clinical practice, especially in an endemic area of viral hepatitis. The purpose of this study isto prospectively assess the role of F-fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography/computed tomography (PET/CT) in indeterminate infiltrative hepatic lesions seen in conventional CT or magnetic resonance imaging (MRI).
  
  
  METHODS
  Dual-phase FDG-PET/CT was performed on35consecutive patients with indeterminate infiltrative hepatic lesions in CT or MRI. The variables analyzed included visual score and maximum standardized uptakevalue. Final diagnosis was histopathology orclinicalfollow-up for at least 12 months.
  
  
  RESULTS
  Malignancy was proven in 28 patients and there were benign strictures in seven patients. Sensitivity, specificity, and overall diagnostic accuracy of FDG-PET/CT using visual score were 85.7% (24/28), 71.4% (5/7), and 82.9% (29/35). Early and delayed maximum standardized uptake values were significantly higher in infiltrative hepatic malignancies than in benign lesions. Furthermore, PET/CT detected 13 unexpected distant metastatic foci notseen in other imaging studies. Thirteen patients (37.1%)had the plans of clinical treatment altered by FDG-PET/CT alone.
  
  
  CONCLUSIONS
  FDG-PET/CT can help to clarify the diagnosis of indeterminate infiltrative hepatic lesions in CT or MRI. Inthis patient population, FDG-PET/CT may hold promisein the detection of unsuspected occult metastases, facilitating decision making and treatment planning.
authors.affiliation: Department of Nuclear Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
authors.forename: Mei-Fang
authors.initials: MF
authors.lastname: Cheng
authors.forename: Yen-Wen
authors.initials: YW
authors.lastname: Wu
authors.forename: Kao-Lang
authors.initials: KL
authors.lastname: Liu
authors.forename: Ruoh-Fang
authors.initials: RF
authors.lastname: Yen
authors.forename: Yao-Ming
authors.initials: YM
authors.lastname: Wu
authors.forename: Chiun
authors.initials: C
authors.lastname: Hsu
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chang
authors.forename: Kai-Yuan
authors.initials: KY
authors.lastname: Tzen
authors.forename: Hsiu-Po
authors.initials: HP
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D019353:Endemic Diseases; D005260:Female; D019788:Fluorodeoxyglucose F18; D006525:Hepatitis, Viral, Human / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013624:Taiwan / Q000453:epidemiology; D014055:Tomography, Emission-Computed / Q000379:methods*; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18