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直肠癌灌注 CT 与动态对比增强磁共振成像的比较。

Comparison between perfusion computed tomography and dynamic contrast-enhanced magnetic resonance imaging in rectal cancer.

机构信息

Department of Radiation Oncology, Maastricht University Medical Center, GROW School for Oncology and Developmental Biology, Maastricht, The Netherlands.

出版信息

Int J Radiat Oncol Biol Phys. 2010 Jun 1;77(2):400-8. doi: 10.1016/j.ijrobp.2009.05.015. Epub 2009 Sep 3.

Abstract

PURPOSE

To compare pretreatment scans with perfusion computed tomography (pCT) vs. dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in rectal tumors.

METHODS AND MATERIALS

Nineteen patients diagnosed with rectal cancer were included in this prospective study. All patients underwent both pCT and DCE-MRI. Imaging was performed on a dedicated 40-slice CT-positron emission tomography system and a 3-T MRI system. Dynamic contrast enhancement was measured in tumor tissue and the external iliac artery. Tumor perfusion was quantified in terms of pharmacokinetic parameters: transfer constant K(trans), fractional extravascular-extracellular space v(e), and fractional plasma volume v(p). Pharmacokinetic parameter values and their heterogeneity (by 80% quantile value) were compared between pCT and DCE-MRI.

RESULTS

Tumor K(trans) values correlated significantly for the voxel-by-voxel-derived median (Kendall's tau correlation, tau = 0.81, p < 0.001) and 80% quantile (tau = 0.54, p = 0.04), as well as for the averaged uptake (tau = 0.58, p = 0.03). However, no significant correlations were found for v(e) and v(p) derived from the voxel-by-voxel-derived median and 80% quantile and derived from the averaged uptake curves.

CONCLUSIONS

This study demonstrated for the first time that pCT provides K(trans) values comparable to those of DCE-MRI. However, no correlation was found for the v(e) and v(p) parameters between CT and MRI. Computed tomography can serve as an alternative modality to MRI for the in vivo evaluation of tumor angiogenesis in terms of the transfer constant K(trans).

摘要

目的

比较直肠肿瘤患者的预处理扫描与灌注 CT(pCT)和动态对比增强磁共振成像(DCE-MRI)。

方法和材料

本前瞻性研究纳入了 19 例经诊断为直肠癌的患者。所有患者均接受了 pCT 和 DCE-MRI 检查。成像在专用的 40 层 CT-正电子发射断层扫描系统和 3-T MRI 系统上进行。在肿瘤组织和髂外动脉中测量动态对比增强。根据药代动力学参数(转移常数 K(trans)、血管外-细胞外空间分数 v(e)和血浆体积分数 v(p))量化肿瘤灌注。比较了 pCT 和 DCE-MRI 之间的药代动力学参数值及其异质性(通过 80%分位数值)。

结果

肿瘤 K(trans)值在体素级别的中位数(Kendall tau 相关,tau = 0.81,p < 0.001)和 80%分位数(tau = 0.54,p = 0.04)以及平均摄取值(tau = 0.58,p = 0.03)方面具有显著相关性。然而,对于从体素级别的中位数和 80%分位数以及平均摄取曲线推导得出的 v(e)和 v(p)值,未发现显著相关性。

结论

本研究首次证明 pCT 可提供与 DCE-MRI 相当的 K(trans)值。然而,CT 和 MRI 之间未发现 v(e)和 v(p)参数的相关性。在体内评估肿瘤血管生成方面,CT 可作为 MRI 的替代方式,用于转移常数 K(trans)的评估。

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