Altenbernd Jens, Wetter Axel, Forsting Michael, Umutlu Lale
Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany.
Eur J Radiol Open. 2016 Aug 25;3:230-5. doi: 10.1016/j.ejro.2016.08.002. eCollection 2016.
The aim of this prospective study was to examine the diagnostic value of dual-energy CT (DECT) in the assessment of response of HCC after radioembolisation (RE).
40 HCC patients with 82 measurable target lesions were included in this study. At baseline and follow-up examination target lesions were evaluated with (IU), AASLD and Choi measurement criteria. Disease control was defined as the sum of complete response (CR), partial response (PR), progression disease (PD) and stable disease (SD).
With Choi and IU more patients were considered than PR and less than PD and SD. According to AASLD more patients were measured as SD and PD than PR. 26/40 patients were classified as PR with IU. In contrast measurements with AASLD in only 8/26 patients were also classified as PR. 6/12 SD patients measured with IU were measured as PD with AASLD. 4/26 patients classified with IU as PR were described as SD with CHOI, 10/14 SD patients measured with CHOI were SD according to IU, the other 4 patients were PR with IU. 2/4 PD patients according to CHOI were SD with IU.
More patients by IU were classified as SD versus PD and PR versus SD. We attribute this to the more detailed consideration of the HU differences between the virtual native and contrast-enhanced series generated by DECT. Iodine uptake (IU) in HCC measured and visualized with DECT is a promising imaging method for the assessment of treatment response after radioembolisations.
-dual energy CT of hypervascular tumors such as HCC allows to quantify contrast enhancement without native imaging. -this can be used to evaluate the therapy response after Radioembolization.
本前瞻性研究的目的是探讨双能CT（DECT）在评估肝癌经动脉放射性栓塞术（RE）后反应中的诊断价值。
本研究纳入40例肝癌患者，共82个可测量的靶病灶。在基线和随访检查时，采用（IU）、美国肝病研究学会（AASLD）和Choi测量标准对靶病灶进行评估。疾病控制定义为完全缓解（CR）、部分缓解（PR）、疾病进展（PD）和疾病稳定（SD）的总和。
与PR相比，Choi和IU标准下被判定为PR的患者更多，而被判定为PD和SD的患者更少。根据AASLD标准，被判定为SD和PD的患者比PR更多。26/40例患者根据IU标准被分类为PR。相比之下，根据AASLD标准，在这26例患者中只有8例也被分类为PR。12例根据IU标准被判定为SD的患者中，有6例根据AASLD标准被判定为PD。26例根据IU标准被分类为PR的患者中，有4例根据Choi标准被描述为SD，14例根据Choi标准被判定为SD的患者中，有10例根据IU标准也为SD，另外4例根据IU标准为PR。4例根据Choi标准被判定为PD的患者中，有2例根据IU标准为SD。
与PD和PR与SD相比，更多患者根据IU标准被分类为SD。我们将此归因于对DECT生成的虚拟平扫和增强系列之间HU差异的更详细考量。用DECT测量和可视化的肝癌碘摄取（IU）是评估放射性栓塞术后治疗反应的一种有前景的成像方法。
