Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, NO1630, Dongfang Road, Shanghai 200127, China.
Acad Radiol. 2013 Aug;20(8):947-56. doi: 10.1016/j.acra.2013.02.011.
To investigate the value of iodine-based material decomposition images produced via spectral computed tomography (CT) in differentiating prostate cancer (PCa) from benign prostate hyperplasia (BPH).
Fifty-six male patients underwent CT examination with spectral imaging during arterial phase (AP), venous phase (VP), and parenchymal phase (PP) of enhancement. Iodine concentrations of lesions were measured and normalized to that of the obturator internus muscle. Lesion CT values at 75 keV (corresponding to the energy of polychromatic images at 120 kVp) were measured and also normalized; their differences between AP and VP, VP and PP, and PP and AP were also obtained. The two-sample t-test was performed for comparisons. A receiver operating characteristic curve was generated to establish the threshold for normalized iodine concentration (NIC).
Fifty-two peripheral lesions were found, which were confirmed by biopsy as 28 cases of PCa and 24 BPHs. The NICs of prostate cancers significantly differed from those of the BPHs: 2.38 ± 1.72 compared with 1.21 ± 0.72 in AP, respectively, and 2.67 ± 0.61 compared with 2.27 ± 0.77 in VP. Receiver operating characteristic analysis indicated that an NIC of 1.24 in the AP provided a sensitivity of 88% and a specificity of 71% for differentiating PCa from BPH.
Spectral CT imaging enabled quantitative depiction of contrast medium uptake in prostatic lesions and improved sensitivity and specificity for differentiating PCa from BPH.
研究能谱 CT 碘基物质分解图像在鉴别前列腺癌（PCa）与前列腺增生（BPH）中的作用。
56 例男性患者行 CT 增强动脉期（AP）、静脉期（VP）和实质期（PP）扫描，获得碘浓度值并与闭孔内肌进行标准化处理。测量病变部位在 75keV 时的 CT 值（对应 120kVp 时的多光谱图像能量），并进行标准化处理，获得 AP 与 VP、VP 与 PP、PP 与 AP 之间的差值。采用两样本 t 检验进行比较。生成受试者工作特征曲线以确定标准化碘浓度（NIC）的阈值。
共发现 52 个外周病变，经活检证实 28 例为 PCa，24 例为 BPH。PCa 的 NIC 与 BPH 显著不同：AP 时分别为 2.38±1.72 与 1.21±0.72，VP 时分别为 2.67±0.61 与 2.27±0.77。受试者工作特征分析表明，AP 时 NIC 为 1.24 时，对 PCa 与 BPH 的鉴别具有 88%的敏感性和 71%的特异性。
能谱 CT 成像可定量描述前列腺病变对比剂摄取情况，提高 PCa 与 BPH 的鉴别诊断的敏感性和特异性。
