Center for Liver Cancer, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea.
Eur J Radiol. 2011 Nov;80(2):e188-94. doi: 10.1016/j.ejrad.2011.06.009. Epub 2011 Jun 25.
To evaluate the clinical benefits of noncontrast chest computed tomography (CT) immediately after transarterial chemoembolization in patients with hepatocellular carcinoma and to assess the effect of radiation reduction on image quality in low-dose scanning.
From June to October 2010, we performed standard-dose, noncontrast chest CTs immediately after transarterial chemoembolization in 160 patients and low-dose CTs in 88 patients. We reviewed the entire noncontrast chest CTs and follow-up CTs to reveal the clinical benefits of CT evaluation immediately after transarterial chemoembolization. Using two independent readers, we also retrospectively evaluated the radiation dose and image quality in terms of the image noise, contrast between the liver parenchyma and iodized oil and diagnostic acceptability for the evaluation of treatment response after transarterial chemoembolization.
In 5.2% of the patients, additional treatment was performed immediately after the interpretation of the noncontrast chest CT, and additional pulmonary lesions were found in 8.5% of the patients. The measured mean dose-length product for the low-dose scanning was 18.4% of that of the standard-dose scanning. The image noise was significantly higher with the low-dose scanning (p<0.001). However, all of the low-dose CT scans were diagnostically acceptable, and the mean scores for the subjective assessments of the contrast and diagnostic acceptability showed no significant differences for either reader.
A noncontrast chest CT immediately after transarterial chemoembolization has some clinical benefits for immediate decision making and detecting pulmonary lesions. Low-dose, noncontrast chest CTs immediately after transarterial chemoembolization consistently provide diagnostically acceptable images and information on treatment response in patients who have undergone transarterial chemoembolization.
评估肝癌患者经肝动脉化疗栓塞术（TACE）后立即行非增强胸部 CT 的临床获益，并评估低剂量扫描对图像质量的放射剂量降低效果。
2010 年 6 月至 10 月，我们对 160 例患者进行了标准剂量非增强胸部 CT 检查，对 88 例患者进行了低剂量 CT 检查。我们回顾了所有非增强胸部 CT 和随访 CT，以显示 TACE 后立即行 CT 评估的临床获益。使用两名独立的读者，我们还回顾性地评估了放射剂量和图像质量，包括图像噪声、肝实质与碘化油之间的对比度以及 TACE 后评估治疗反应的诊断可接受性。
在 5.2%的患者中，在非增强胸部 CT 解读后立即进行了额外的治疗，在 8.5%的患者中发现了额外的肺部病变。低剂量扫描的平均剂量长度乘积为标准剂量扫描的 18.4%。低剂量扫描的图像噪声显著升高（p<0.001）。然而，所有低剂量 CT 扫描均具有诊断可接受性，且两位读者的主观评估对比度和诊断可接受性的平均评分均无显著差异。
TACE 后立即行非增强胸部 CT 检查具有一些临床获益，可立即做出决策并检测肺部病变。TACE 后行低剂量非增强胸部 CT 检查可始终提供具有诊断可接受性的图像和关于治疗反应的信息。
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