经导管化疗栓塞后碘油沉积的定量评估：锥形束 CT 与多排 CT 的比较。
Quantitative assessment of lipiodol deposition after chemoembolization: comparison between cone-beam CT and multidetector CT.
机构信息
Russell H. Morgan Department of Radiology and Radiological Science, Division of Vascular and Interventional Radiology, The Johns Hopkins Hospital, Sheikh Zayed Tower, Suite 7203, 1800 Orleans Street, Baltimore, MD, 21287.
出版信息
J Vasc Interv Radiol. 2013 Dec;24(12):1837-44. doi: 10.1016/j.jvir.2013.08.017. Epub 2013 Oct 1.
PURPOSE
To evaluate the ability of cone-beam computed tomography (CBCT) performed directly after transarterial chemoembolization to assess ethiodized oil (Lipiodol) deposition in hepatocellular carcinoma (HCC) and compare it with unenhanced multidetector computed tomography (CT).
MATERIALS AND METHODS
Conventional transarterial chemoembolization was used to treat 15 patients with HCC, and CBCT was performed to assess Lipiodol deposition directly after transarterial chemoembolization. Unenhanced multidetector CT was performed 24 hours after transarterial chemoembolization. Four patients were excluded because the margin of tumor or area of Lipiodol deposition was unclear. The image enhancement density of the entire tumor and liver parenchyma was measured by ImageJ software, and tumor-to-liver contrast (TLC) was calculated. In addition, volumetric measurement of tumor and Lipiodol was performed by semiautomatic three-dimensional volume segmentation and compared using linear regression to evaluate consistency between the two imaging modalities.
RESULTS
The mean value of TLC on CBCT was not significantly different from TLC on multidetector CT (337.7 HU ± 233.5 vs 283.0 HU ± 152.1, P = .103).The average volume of the whole tumor and of only the regions with Lipiodol deposition and the calculated average percentage of Lipiodol retention on CBCT were not significantly different compared with multidetector CT (tumor volume, 9.6 cm(3) ± 11.8 vs 10.8 cm(3) ± 14.2, P = .142; Lipiodol volume, 6.3 cm(3) ± 7.7 vs 7.0 cm(3) ± 8.1, P = .214; percentage of Lipiodol retention, 68.9% ± 24.0% vs 72.2% ± 23.1%, P = .578). Additionally, there was a high correlation in the volume of tumor and Lipiodol between CBCT and multidetector CT (R(2) = 0.919 and 0.903).
CONCLUSIONS
The quantitative image enhancement and volume analyses demonstrate that CBCT is similar to multidetector CT in assessing Lipiodol deposition in HCC after transarterial chemoembolization.
目的
评估经动脉化疗栓塞术（TACE）后即刻行锥形束 CT（CBCT）评估肝细胞癌（HCC）中碘化油（Lipiodol）沉积的能力，并与未增强多排 CT（MDCT）进行比较。
材料与方法
对 15 例 HCC 患者行常规 TACE 治疗，在 TACE 后即刻行 CBCT 以评估 Lipiodol 沉积。TACE 后 24 小时行 MDCT 平扫。因肿瘤边界或 Lipiodol 沉积区域不清晰，排除 4 例患者。应用 ImageJ 软件测量全肿瘤及肝实质的图像增强密度，计算肿瘤-肝对比（TLC）。另外，通过半自动三维容积分割对肿瘤和 Lipiodol 进行容积测量，并用线性回归进行比较，以评估两种成像方式的一致性。
结果
CBCT 的 TLC 值与 MDCT 无显著差异（337.7 HU ± 233.5 比 283.0 HU ± 152.1，P =.103）。CBCT 与 MDCT 比较，全肿瘤平均体积、仅含 Lipiodol 沉积区域的平均体积以及计算的 Lipiodol 保留平均百分比均无显著差异（肿瘤体积，9.6 cm(3) ± 11.8 比 10.8 cm(3) ± 14.2，P =.142；Lipiodol 体积，6.3 cm(3) ± 7.7 比 7.0 cm(3) ± 8.1，P =.214；Lipiodol 保留百分比，68.9% ± 24.0% 比 72.2% ± 23.1%，P =.578）。此外，CBCT 与 MDCT 之间肿瘤和 Lipiodol 体积相关性高（R(2) = 0.919 和 0.903）。
结论
定量图像增强和容积分析表明，CBCT 在评估 HCC 经 TACE 后 Lipiodol 沉积方面与 MDCT 相似。
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