摘要
目的通过比较双源CT双能量成像(DECT)肺癌化疗前后变化,探索DECT对非小细胞肺癌(NSCLC)化疗评估疗效的价值。方法收集22例经临床评估不能手术,但需要接受化学治疗的原发性NSCLC患者,所有病例均经穿刺活检证实,其中腺癌12例,鳞癌10例(男性16例,女性6例,年龄41~76岁,平均年龄61.4岁)。使用双源CT分别在患者化疗前及化疗2周期后行双能量模式扫描,其中增强扫描时间为注入对比剂后的主动脉达峰时及第100s。测量各时期所有病灶化疗前后碘值,并分析比较病灶化疗前后碘值的变化规律。结果部分缓解组(PR组)8例,稳定组(SD组)13例,病情进展组(PD组)1例,无完全缓解组。化疗前各时期标准化碘值PR组均较SD组高,但是只有主动脉达峰时两者之间的差异具有统计学意义(P<0.05)。PR组各时期化疗前后标准化碘值改变量均大于SD组(P<0.05)。各时期化疗前后标准化碘值改变量的ROC曲线均有助于预测疗效,其中主动脉达峰时曲线下面积约为0.909(P<0.05),敏感度为100%,特异性69.2%;第100s曲线下面积约为0.971(P<0.05),敏感度为87.5%,特异性100%。结论双源CT双能量成像有助于原发性肺癌的化疗疗效评估。
Objective By comparing the changes of dual-source CT dual-energy imaging(DECT) before and after chemotherapy for lung cancer, and explore the value of DECT in evaluating the efficacy of chemotherapy for non-small cell lung cancer(NSCLC). Methods To collect 22 cases with primary non-small cell lung cancer and all of them cannot receive operation but chemotherapy through clinical evaluation.All the cases are newly diagnosed and confirmed by pathology results, including 12 cases of adenocarcinoma,10 cases of squamous cell carcinoma.Among the patients,16 cases of male, 6 cases of female, age range41-76, mean age 61.4 years. Applying the German SIEMENS second generation dual-energy CT to exam the chest in dual-energy mode before and after 2 cycles of chemotherapy. The scanning time for enhancement were at the aorta peak and 100 s after the injection of iodinated contrast material.then analysis the changes of iodine value of the lesions before and after chemotherapy. Results There were 8 cases in the partial remission group(PR group), 13 cases in the stable group(SD group), 1 case in the disease progression group(PD group), and no complete remission group. Before chemotherapy, the standardized iodine value of PR group was higher than the SD group, but the difference was statistically significant only when the aorta reached peak(P<0.05). The change of standardized iodine value before and after chemotherapy in PR group was greater than that in SD group(P<0.05). The ROC curves of the changes of standardized iodine value before and after chemotherapy were helpful to predict the curative effect, among which the area under the curve when the aorta reached peak was about 0.909(P<0.05), the sensitivity was 100%, and the specificity was 69.2%. The area under the 100 s curve was about 0.971(P<0.05), the sensitivity was 87.5%, and the specificity was 100%. Conclusion Dual-source CT with dual-energy imaging evaluate the efficacy of chemotherapy for primary non-small cell lung cancer.
作者
张周芳
张玉忠
彭雪华
黄洁惠
邵国良
ZHANG Zhou-fang;ZHANG Yu-zhong;PENG Xue-hua(Department of Radiology,Shenzhen Longhua People Hospital,Shenzhen 518109,Guangdong Province,China)
出处
《中国CT和MRI杂志》
2020年第6期55-58,F0002,共5页
Chinese Journal of CT and MRI
关键词
双源CT
肺癌
化疗
疗效
Dual-source CT
Lung Cancer
Chemotherapy
Curative Effect
