Hepatosellüler Karsinom Tanısında F-18 FDG PET/BT ile Ga-68 PSMA PET/BT Çalışmaların Rolü

Abstract

Amaç: Bu çalışmanın amacı, Flor-18 florodeoksiglukoz pozitron emisyon tomografi/bilgisayarlı tomografi (F-18 FDG PET/BT) ile Galyum-68 prostat spesifik membran antijeni (Ga-68 PSMA) PET/BT’den elde edilen parametreleri karşılaştırmak ve Ga-68 PSMA PET/BT’nin hepatoselüler karsinom (HCC) tanısı ve klinik yönetimine katkısını araştırmaktı. Yöntemler: Manyetik rezonans görüntüleme (MRI), alfa-fetoprotein (AFP) değeri ve klinik bulgular ile HCC tanısı konulan 16 hastaya, hem F-18 FDG PET/BT, hem de Ga-68 PSMA PET/BT incelemesi yapıldı. Hastalar, karaciğerde saptanan primer kitleye ait görüntüleme bulgularına göre üç gruba ayrıldı: Grup 1 (F-18 FDG pozitif ve Ga-68 PSMA pozitif), Grup 2 (F-18 FDG negatif ve Ga-68 PSMA pozitif) ve Grup 3 (F-18 FDG negatif ve Ga-68 PSMA negatif). Ayrıca her hastanın AFP değerleri kaydedildi. Bulgular: Çalışmaya toplam 16 hasta dâhil edildi. 16 hastanın 14’ünde (%87,5) Ga-68 PSMA PET/BT ile karaciğer tümörlerinde arka plan düzeyinin üzerinde aktivite tutulumu gözlendi. F-18 FDG PET/BT’de ise bu oran %75 (12 hasta) olarak bulundu. Tümör background oranı (TBR), FDG için ortalama 1.97 (±1.04), Ga-68 PSMA için ise ortalama 2.77 (±2.27) olarak saptandı. Ayrıca 6 hastada (%37,5) ekstrahepatik metastatik odaklarda da belirgin patolojik aktivite tutulumları tespit edildi. Sonuç: Ga-68 PSMA PET/BT'nin, HCC hastalarında primer tümörlerin saptanmasında F-18 FDG PET/BT’ye kıyasla daha yüksek tanısal performans gösterdiği ortaya konmuştur. Bu bulgu, Ga-68 PSMA PET/BT’nin HCC’nin tanı ve evrelemesinde tamamlayıcı bir rol üstlenebileceğini düşündürmüştür.

Keywords

• F-18 FDG
• Ga-68 PSMA
• hepatoselüler karsinom
• PET/BT

Ethical Statement

Bu çalışma Dicle Üniversitesi Tıp Fakültesi Nükleer Tıp Anabilim Dalı’nda gerçekleştirildi. Etik onay, Dicle Üniversitesi Klinik Araştırmalar Etik Kurulu’ndan alındı (IRB No ve tarih: 92/ 15.03.2023).

The Role of F-18 FDG PET/CT and Ga-68 PSMA PET/CT on the Diagnosis of Hepatocellular Carcinoma

Abstract

Objective: The aim of this study was to compare the parameters obtained from fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) and gallium-68 prostate-specific membrane antigen (Ga-68 PSMA) PET/CT, and to investigate the potential contribution of Ga-68 PSMA PET/CT in the diagnosis and clinical management of hepatocellular carcinoma (HCC). Methods: Both F-18 FDG PET/CT and Ga-68 PSMA PET/CT examinations were performed in 16 patients diagnosed with HCC based on Magnetic resonance imaging (MRI), alpha-fetoprotein (AFP) values and clinical findings. Patients were divided into three groups according to the imaging characteristics of the primary hepatic lesion: Group 1 (F-18 FDG positive and Ga-68 PSMA positive), Group 2 (F-18 FDG negative and Ga-68 PSMA positive), and Group 3 (F-18 FDG negative and Ga-68 PSMA negative). Additionally, AFP values of each patient were recorded. Results: A total of 16 patients were included in the study. In 14 of 16 patients (87.5%), activity showed higher uptake than the surrounding tissue levels was observed in liver tumors with Ga-68 PSMA PET/CT. This rate was found to be 75% (12 patients) with F-18 FDG PET/CT. The mean tumor-to-background ratio (TBR) was 1.97 (±1.04) for FDG and 2.77 (±2.27) for Ga-68 PSMA. Additionally, significant pathological activity uptake was detected in extrahepatic metastatic foci in 6 patients (37.5%). Conclusion: Ga-68 PSMA PET/CT demonstrated higher diagnostic performance than F-18 FDG PET/CT in detecting primary tumors in HCC patients. This finding suggests that Ga-68 PSMA PET/CT may play a complementary role in the diagnosis and staging of HCC.

Keywords

• F-18 FDG
• Ga-68 PSMA
• hepatocellular carcinoma
• PET/CT.

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