肝转移瘤¹⁸F-FDG PET/CT研究进展与展望

Progress and prospects of ¹⁸F-FDG PET/CT in liver metastases

摘要

肝脏是肿瘤转移的常见部位，肝转移瘤常继发于结直肠癌、胰腺癌、黑色素瘤、肺癌和乳腺癌等。在所有恶性肿瘤转移中，肝转移占比近25%，肝转移患者的1年生存率为15.1%。肝转移瘤的早期诊断和精准治疗对改善患者预后至关重要。¹⁸氟-2-脱氧葡萄糖（¹⁸F-fluoro-deoxy-D-glucose，¹⁸F-FDG）PET/CT作为一种功能代谢与解剖结构相结合的影像学检查技术，在肝转移瘤的诊断、分期、治疗方案制定等方面发挥着越来越重要的作用。文章综述了近年来¹⁸F-FDG PET/CT在肝转移瘤研究中的进展，包括在肝转移瘤诊断、鉴别诊断、治疗前评估、疗效评估、预后预测等方面的应用，与其他影像学方法比较的优劣势，在延迟成像、图像优化等技术方面的新进展，在诊断某些疾病时的陷阱，在引导放疗时的作用等。最后，总结了人工智能技术在肝转移瘤诊疗中的应用，并对¹⁸F-FDG PET/CT应用于肝转移瘤的发展方向进行了展望。

Abstract

The liver is a common site for tumor metastases. Liver metastases often occur secondary to malignancies including colorectal cancer，pancreatic cancer，melanoma，lung cancer，and breast cancer，accounting for nearly 25% of all cancer metastases，and the 1-year survival rate for all patients with liver metastases is 15.1%. Early diagnosis and precise treatment are crucial for improving patient prognosis. As an imaging technique that combines functional metabolism with anatomical structure，¹⁸F-fluoro-deoxy-D-glucose（¹⁸F-FDG）PET/CT plays an increasingly important role in the diagnosis，staging，and treatment planning of liver metastases. This article reviews recent advances in ¹⁸F-FDG PET/CT research on liver metastases，including its applications in diagnosis，differential diagnosis，pre-treatment evaluation，efficacy assessment，and prognosis prediction；its advantages and disadvantages in comparative imaging；new technological developments such as delayed imaging and image optimization；diagnostic pitfalls in certain diseases；and its role in guiding radiotherapy. Finally，it summarizes the application of artificial intelligence technology in the diagnosis and treatment of liver metastases and provides prospects on the future development directions of ¹⁸F-FDG PET/CT in this field.

关键词

¹⁸氟-2-脱氧葡萄糖 / 肝转移瘤 / PET/CT / 人工智能

Key words

¹⁸F-fluoro-deoxy-D-glucose / liver metastases / PET/CT / artificial intelligence

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基金资助

国家重点研发计划(2020YFA0713800)