Detection ofthe recurrent epithelioid hemangioendothelioma in the liver by means of dual-time-point 18F-FDG PET/CT
Abstract
Aim: To present a rare case report about 38-year-old man with recurrence of the epithelioid hemangioendothelioma in the liver which was detected by means of dual-time 18F-FDG PET/CT. Methods: The patient was examined for a few weeks lasting low back pain.
The abdomen ultrasound and computed tomography detected multifocal lesions in the liver. The epithelioid hemangioendothelioma was proven by biopsy and the patient underwent chemotherapy.
The finding had been stable without changes on the repeated follow-up radiology imaging for 12 years. A new lesion in the right liver lobe was detected on the next follow-up imaging, which was suspected for the recurrence.
The PET/CT scan from base of skull to mid femur was obtained 60 minutes after intravenous injection of 18F-FDG. The PET scan acquisition time was 2.5 minutes per bed position and seven bed positions were necessary.
Contrast-enhanced CT (venous phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenuation correction. Results: No pathological 18F-FDG uptake was detected on early PET/CT scan and so the next delayed PET/CT imaging was performed 3 hours after 18F-FDG injection.
The increased focal 18F-FDG uptake was demonstrated in the incriminated lesion in the right liver lobe on the delayed PET/CT images, this lesion showed a significant increase of tumor lesion-to-liver background ratio. The next distant or locoregional focus of the increased 18F-FDG uptake were excluded.
The hepatic recurrence of epithelioid hemangioendothelioma was proven by biopsy. Conclusion: In this report dual-time-point 18F-FDG PET/CT imaging correctly detected recurrent epithelioid hemangioendothelioma in a liver.
The delayed scan significantly improved sensitivity of the PET/CT examination and detected the hypermetabolic lesion in a liver.