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The Pitfall Caused by the Attenuation Correction CT in FDG PET/CT in Hepatopancreatic Cancer: A Case Report

案例報告:以氟化葡萄糖正子造影/電腦斷層評估肝胰癌症時因衰減校正電腦斷層導致之誤判

摘要


F-18 FDG PET is a useful functional image technique to evaluate the disease extent in many cancers by detecting hypermetabolic lesions. In combination with anatomical imaging tools such as computed tomography (CT) or magnetic resonance image, extra anatomical information could be provided for better lesion localization. However, the relatively lower spatial resolution of the "attenuation correction" CT or respiratory motion artifacts in positron emission tomography (PET)/CT fusion imaging may sometimes fail to correctly portray the real anatomical relationship between the lesion and nearby structures. We presented a case, in which the "attenuation correction" CT incorrectly delineated the anatomical relationship, misleading to an inaccurate impression. We recommend PET with contrast-enhanced CT, with focal full diagnostic CT, or with respiratory gating techniques might be an option in selected cases to avoid this kind of pitfall.

並列摘要


氟18氟化葡萄糖正子造影是一項透過偵測高代謝性病灶以評估癌症侵犯程度之功能性影像技術。結合解剖性影像如電腦斷層、磁振造影,可提供解剖資訊以協助病灶定位。然而,由於正子造影中使用的「衰減校正」電腦斷層其空間分辨率較低,或因病人呼吸動作較大導致之運動假影,有時可能無法正確指出病灶與附近結構之間的真實解剖關係。本案例報告中,因「衰減校正」電腦斷層錯誤地描繪了解剖關係,從而導致不正確的臆斷。我們建議在特定個案中,也許可以透過使用顯影劑增強、局部高能量診斷用電腦斷層或呼吸校正技術來避免此類陷阱。

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