Value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma after TACE treatment
10.3760/cma.j.issn.0253-3766.2015.03.011
- VernacularTitle:宝石能谱 CT 成像碘含量测定法在肝细胞癌患者经动脉化疗栓塞术后随访中的应用
- Author:
Gusheng XING
1
;
Shuang WANG
;
Chenrui LI
;
Xinming ZHAO
;
Chunwu ZHOU
Author Information
1. 100021,中国医学科学院 北京协和医学院肿瘤医院影像诊断科
- Keywords:
Carcinoma,heptocellular;
Spectral computed tomography;
Diagnosis;
Transcatheter arterial chemoebolization
- From:
Chinese Journal of Oncology
2015;(3):208-212
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the value of quantitative iodine-based material decomposition images with gemstone spectral CT imaging in the follow-up of patients with hepatocellular carcinoma ( HCC) after transcatheter arterial chemoebolization ( TACE ) . Methods Consecutive 32 HCC patients with previous TACE treatment were included in this study.For the follow-up, arterial phase ( AP) and venous phase ( VP) dual-phase CT scans were performed with a single-source dual-energy CT scanner ( Discovery CT 750HD, GE Healthcare).Iodine concentrations were derived from iodine-based material-decomposition images in the liver parenchyma, tumors and coagulation necrosis ( CN ) areas.The iodine concentration difference (ICD) between the arterial-phase (AP) and venal-phase (VP) were quantitatively evaluated in different tissues.The lesion-to-normal parenchyma iodine concentration ratio ( LNR) was calculated.ROC analysis was performed for the qualitative evaluation, and the area under ROC ( Az ) was calculated to represent the diagnostic ability of ICD and LNR.Results In all the 32 HCC patients, the region of interesting ( ROI ) for iodine concentrations included liver parenchyma ( n =42 ) , tumors ( n =28 ) and coagulation necrosis ( n =24).During the AP the iodine concentration of CNs ( median value 0.088μg/mm3 ) appeared significantly higher than that of the tumors ( 0.064 μg/mm3 , P =0.022 ) and liver parenchyma (0.048μg/mm3 ,P=0.005) .But it showed no significant difference between liver parenchyma and tumors (P=0.454).During the VP the iodine concentration in hepatic parenchyma (median value 0.181 μg/mm3) was significantly higher than that in CNs (0.140 μg/mm3,P=0.042).There was no significant difference between liver parenchyma and tumors, CNs and tumors (both P>0.05).The median value of ICD in CNs was 0.006 μg/mm3 , significantly lower than that of the HCC (0.201 μg/mm3 , P<0.001) and hepatic parenchyma (0.117 μg/mm3, P <0.001).The ICDs in tumors and hepatic parenchyma showed no significant difference (P =0.829).During the AP, the LNR had no significant difference between CNs and tumors ( a median value 1.805 vs.1.310, P=0.389) , and during the VP, the difference was also non-significant (the median value 0.647 vs.0.713, P=0.660).The mean Az value of ICDs for evaluation of surviving tumor tissues was 0.804, whiles LNR measured a disappointing result in both AV images and VP images.Conclusion Quantitative iodine-based material decomposition images with gemstone spectral CT imaging can improve the diagnostic efficacy of CT imaging for HCC patients after TACE treatment.
