Burke Michael C, Garg Ankur, Youngner Jonathan M, Deshmukh Swati D, Omar Imran M
Department of Radiology, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 800, Chicago, IL, 60611, USA.
Skeletal Radiol. 2019 Apr;48(4):605-613. doi: 10.1007/s00256-018-3087-1. Epub 2018 Oct 20.
Our purpose was to determine whether dual-energy CT (DECT), specifically the bone marrow setting of the virtual noncalcium (VNCa) algorithm, could be used to identify and accurately biopsy suspected bone malignancies that were visible on magnetic resonance imaging (MRI), nuclear bone scintigraphy, or positron-emission tomography/computed tomography (PET/CT), but occult on monoenergetic computed tomography (CT) by virtue of being either isodense or nearly isodense to surrounding normal bone.
We present 4 cases in which DECT was used to detect various malignant bone lesions and was successfully used to direct percutaneous DECT-guided bone biopsies.
Two of the lesions were solid tumor metastases (breast and prostate carcinoma), whereas two others were hematological malignancies (leukemia and lymphoma). This technique enabled us to confidently and accurately direct the biopsy needle into the target lesion.
The authors demonstrate that the DECT VNCa bone marrow algorithm may be helpful in identifying isodense bone lesions of various histologies and may be used to guide percutaneous bone biopsies. This technique may help to maximize diagnostic yield, minimize the number of passes into the region of concern, and prevent patients from undergoing repeat biopsy.
我们的目的是确定双能CT（DECT），特别是虚拟去钙（VNCa）算法的骨髓模式，是否可用于识别磁共振成像（MRI）、核素骨显像或正电子发射断层扫描/计算机断层扫描（PET/CT）上可见但在单能计算机断层扫描（CT）上因与周围正常骨等密度或近乎等密度而隐匿的可疑骨恶性肿瘤，并准确引导活检。
我们展示了4例使用DECT检测各种恶性骨病变并成功用于引导经皮DECT引导下骨活检的病例。
其中2例病变为实体瘤转移（乳腺癌和前列腺癌），另外2例为血液系统恶性肿瘤（白血病和淋巴瘤）。该技术使我们能够自信且准确地将活检针引导至目标病变。
作者证明DECT VNCa骨髓算法可能有助于识别各种组织学类型的等密度骨病变，并可用于引导经皮骨活检。该技术可能有助于提高诊断率，减少进入可疑区域的穿刺次数，并防止患者接受重复活检。
