The Diagnostic Efficacy and Lesion Detection Advantages of 18F-FDG PET/CT and Enhanced MRI in Hepatic Malignancies

Liver disease is a major challenge for global public health, covering a wide range from mild liver dysfunction to serious diseases such as cirrhosis and liver cancer. Globally, the high incidence rate and mortality of liver diseases have led to a huge socio-economic burden, especially in developing countries. Primary liver cancer, especially hepatocellular carcinoma (HCC), is the fifth most common cancer and the third leading cause of cancer death worldwide. In addition, the liver is a common site of metastasis for various cancers, and the occurrence of liver metastasis significantly affects the prognosis and treatment strategies of patients. In this context, accurately diagnosing the nature of liver lesions has become the key to improving patient treatment outcomes. Distinguishing between benign and malignant liver lesions is crucial for avoiding unnecessary invasive interventions and ensuring timely and appropriate treatment. Similarly, timely identification of liver metastases is crucial for the overall management and improvement of survival rates in cancer patients.

Traditional imaging techniques such as ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) have been widely used for the detection and characterization of liver lesions, but they have limitations in diagnostic specificity and sensitivity, limited recognition of specific pathological features, and insufficient ability to detect small metastases. Positron emission tomography/computed tomography (PET/CT), as a widely used fusion imaging technique, combines the metabolic information of PET with the anatomical information of CT, demonstrating unique value in the diagnosis and treatment evaluation of various tumors. However, PET/CT has specific limitations in its application in liver diseases, especially in analyzing small liver lesions and distinguishing between benign and malignant tumors in the context of cirrhosis, which may be challenging. In addition, the radiation exposure caused by CT components is a significant issue that cannot be ignored in PET/CT examinations.

Relatively speaking, PET/MR combined with 18F-fluorodeoxyglucose (18F-FDG)provides a new diagnostic possibility, especially when used in conjunction with abdominal-enhanced MR on the same machine, which is expected to further improve diagnostic accuracy. However, despite the theoretical superiority of this technology over traditional methods, the actual degree of improvement, scope of application, and impact on clinical decision-making are still unclear. Therefore, despite high expectations for this technology, it is necessary to conduct a comprehensive study to evaluate the specific benefits of 18F-FDG PET/MR combined with abdominal-enhanced MR in the diagnosis of liver lesions, the particular degree of improvement in diagnostic accuracy, and its potential contribution to improving patient treatment outcomes. This not only helps to validate the practical application value of this technology in the diagnosis of liver lesions but also provides evidence for clinical doctors to optimize and personalize patient diagnosis and treatment plans. The results of this study will provide the scientific basis for future clinical practice, ensuring the effective and cost-effective application of this technology in the management of liver diseases.

Study Overview

• Status: Not yet recruiting
• Conditions: Hepatoma
• Intervention / Treatment: Other: PET scan of FDG

Detailed Description

This study is a prospective research design, enrolling 60 patients with suspected liver masses over a one-year period, who will undergo 18F-FDG PET/CT and enhanced MRI examinations.

• Study Type: Observational
• Enrollment (Estimated): 60

Contacts and Locations

• Study Contact: Name: Jie Ding, MD; Phone Number: 17810259215; Email: dingjie940406@163.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

patients with hepatocellular cancer

Description

Inclusion Criteria:

1. Age ≥ 18 years old; Preliminary findings from other routine imaging examinations;
2. Patients suspected of having liver metastasis or liver lesions, based on clinical symptoms and laboratory tests (such as alpha-fetoprotein levels);
3. Preliminary findings from other routine imaging examinations;
4. Able to perform 18F-FDG PET/MR examination and agree to follow the research procedure.

Exclusion Criteria:

1. Patients with a history of allergy to MR contrast agents;
2. Pregnant or lactating women;
3. Patients with severe heart disease, renal failure, liver failure, etc;
4. Patients who are unable to cooperate in completing PET/MR examinations.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

research group; This study adopts a prospective research design, with 60 patients suspected of having liver mass undergoing 18F-FDG PET/enhanced MR examination over one year. The inclusion criteria are as follows: age ≥ 18 years old; Patients suspected of having liver metastasis or liver lesions, based on clinical symptoms and laboratory tests (such as alpha-fetoprotein level); Preliminary findings from other routine imaging examinations; Able to perform 18F-FDG PET/MR examination and agree to follow the research procedure. The exclusion criteria are as follows: patients with a history of allergy to MR contrast agents; Pregnant or lactating women; Patients with severe heart disease, renal failure, liver failure, etc; Patients who are unable to cooperate in completing PET/MR examinations. This study passed the ethical review of Shanghai Oriental Hospital, and patients signed informed consent forms after enrollment.

Other: PET scan of FDG; The enrolled patients will undergo PET examination, and the radiation dose generated during the examination will not cause physiological damage to the patients

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Radioactive uptake	Assess the glucose uptake of the lesions.	After the patient signs the informed consent form and completes the scan, an average of 2 days.
manifestations of lesions on MR	Two physicians will collaboratively document the dimensions of liver lesions.	After the patient signs the informed consent form and completes the scan, an average of 2 days.
manifestations of lesions on MR	Two physicians will collaboratively assess the quantity of lesions.	After the patient signs the informed consent form and completes the scan, an average of 2 days.
Signal characteristics on MRI	Evaluating the MR features of liver lesions, including T1 weighted, T2 weighted, diffusion-weighted imaging (DWI) characteristics, and enhanced features.	After the patient signs the informed consent form and completes the scan, an average of 2 days.

Collaborators and Investigators

• Sponsor: Shanghai East Hospital

Study record dates

Study Major Dates

• Study Start (Estimated): December 1, 2024
• Primary Completion (Estimated): November 30, 2027
• Study Completion (Estimated): November 30, 2027

Study Registration Dates

• First Submitted: October 22, 2024
• First Submitted That Met QC Criteria: November 19, 2024
• First Posted (Estimated): November 22, 2024

Study Record Updates

• Last Update Posted (Estimated): November 22, 2024
• Last Update Submitted That Met QC Criteria: November 19, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: Hepatoma; pet/mr; contrast-enhanced MR
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Neoplasms by Histologic Type; Digestive System Neoplasms; Digestive System Diseases; Liver Diseases; Neoplasms, Glandular and Epithelial; Adenocarcinoma; Carcinoma; Carcinoma, Hepatocellular; Liver Neoplasms
• Other Study ID Numbers: 2024212

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: In order to better protect patient privacy, the trial data will not be made public. Researchers can contact us via email to obtain the data.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No