Department of Radiation Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
J Radiat Res. 2013 Sep;54(5):938-42. doi: 10.1093/jrr/rrt030. Epub 2013 Apr 24.
The purpose of this investigation was to analyze the correlation between CT size and gross pathologic size for subjects with primary hepatocellular carcinoma (HCC). This analysis included 174 patients with HCC who underwent surgery. Enhanced computed tomography (CT) was performed up to 30 days before surgery. After resection, the size of the tumor on gross pathologic examination was recorded. The maximal measurement in one dimension on axial imaging and pathologic examination was extracted for statistical analysis. The clinical and pathologic sizes were compared using a percent size difference (%Δsize) as an end point. A regression analysis was applied to study the association between pathologic and radiographic size. The median radiographic and pathologic size were 70.58 ± 38.9 mm and 68.59 ± 40.56 mm, respectively. The radiographic size was larger than or equal to the pathologic size in 110/174 tumors (63.2%), and smaller in 64/174 (36.8%) tumors. Overall, the radiographic and pathologic sizes were positively correlated (r = 0.983, P = 0.000). CT seemed to overestimate the tumor size by 2.16 mm compared to final pathology (P = 0.024). The median %Δsize was 3.3%. Pathologic tumor size was significantly underestimated in patients with a tumor size 3-5 cm (P = 0.011), Grade I HCC (P = 0.023), with clear boundary (P = 0.013). We concluded that CT size and pathologic size were positively correlated, but differences did exist. Utilizing the radiographic tumor when planning radiation would have covered 63.2% of gross tumors. For a radiographic tumor size < 50 mm, utilizing a 3-mm margin around the radiographic tumor would have covered 90% of gross lesions, while a margin of 5 mm would have covered 95%, and a margin of 15 mm would have covered 100%.
本研究旨在分析原发性肝细胞癌（HCC）患者 CT 大小与大体病理大小之间的相关性。该分析纳入了 174 例接受手术治疗的 HCC 患者。患者在术前 30 天内行增强 CT 检查。术后记录大体病理检查肿瘤的大小。提取轴向影像学和大体病理检查中最大一维测量值进行统计分析。以百分比大小差异（%Δsize）作为终点比较临床和病理大小。应用回归分析研究病理和影像学大小之间的相关性。影像学和大体病理测量的中位数分别为 70.58 ± 38.9 mm 和 68.59 ± 40.56 mm。174 例肿瘤中，110 例（63.2%）影像学大小等于或大于大体病理大小，64 例（36.8%）影像学大小小于大体病理大小。总体而言，影像学和大体病理大小呈正相关（r = 0.983，P = 0.000）。与最终病理相比，CT 似乎高估了肿瘤大小 2.16 mm（P = 0.024）。肿瘤大小为 3-5 cm（P = 0.011）、HCC 分级 I （P = 0.023）、边界清晰（P = 0.013）的患者其大体病理肿瘤大小被明显低估。综上，CT 大小与大体病理大小呈正相关，但存在差异。在规划放疗时利用肿瘤的影像学大小，将覆盖 63.2%的大体肿瘤。对于影像学肿瘤大小＜50 mm，利用 3-mm 影像学肿瘤边缘可覆盖 90%的大体病变，5 mm 边缘可覆盖 95%，15 mm 边缘可覆盖 100%。
