Department of Radiology, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, No. 29 Xinglong Road, Tianning District, Changzhou, Jiangsu, China.
Department of Radiotherapy, Changzhou Second People's Hospital Affiliated to Nanjing Medical University, Changzhou, 213003, China.
BMC Cancer. 2018 Nov 16;18(1):1120. doi: 10.1186/s12885-018-5058-2.
To compare dual energy CT iodine imaging and standardized iodine concentration before and after chemoradiotherapy (CRT) for esophageal cancer and evaluate the efficacy of CRT for EC by examining DECT iodine maps and standard CT values.
The clinical data of 45 patients confirmed by pathology with newly diagnosed esophageal cancer who underwent concurrent CRT from February 2012 to January 2017 in our department of radiology were collected. All patients underwent dual-source dual-energy CT (DECT) before and after CRT. Normalized iodine concentration (NIC) and normalized CT (NCT) corresponding to the overall cancer lesion and its maximum cross-sectional area were observed and compared. Additionally, 30 healthy individuals were compared as control group. After treatment, the patients were divided into two groups according to RECIST1.1: treatment effective group and ineffective group.
There were 33 patients (CR 9, PR 24) in the effective group and 12 patients (SD 12, PD 0) in the ineffective group. There was no significant difference in the NIC-A, NIC-V, NCT-A and NCT-A indexes between the effective group (B group) and the ineffective group (C group) before treatment (P > 0.05). After the treatment, the above-mentioned indexes in the effective group of patients were significantly lower than before treatment, and compared with the ineffective group, the NIC-A, NIC-V, NCT-A and NCT-V values of the effective group were significantly lower than those of ineffective group (P < 0.05). After treatment, the NIC-V and NCT-V in the ineffective group were lower than before treatment, and the difference was statistically significant (P < 0.05). However, their NIC-A and NCT-A were not statistically different from those before treatment (P > 0.05).
Using DECT iodine map, the changes of NIC and NIC before and after CRT in patients with esophageal cancer can evaluate the effect of CRT, and does not increase the radiation dose, so it is suitable for clinical use.
比较双能 CT 碘成像和放化疗前后（CRT）标准化碘浓度，通过检查 DECT 碘图和标准 CT 值评估食管癌 CRT 的疗效。
收集我院放射科 2012 年 2 月至 2017 年 1 月期间 45 例经病理证实的新诊断食管癌并行同期 CRT 的患者的临床资料。所有患者均在 CRT 前后进行双源双能 CT（DECT）检查。观察并比较整体肿瘤病变及其最大横截面积的归一化碘浓度（NIC）和归一化 CT（NCT）。另外，以 30 名健康个体作为对照组。治疗后，根据 RECIST1.1 将患者分为两组：有效组和无效组。
有效组 33 例（CR 9 例，PR 24 例），无效组 12 例（SD 12 例，PD 0 例）。有效组（B 组）和无效组（C 组）治疗前 NIC-A、NIC-V、NCT-A 和 NCT-A 指标无统计学差异（P>0.05）。治疗后，有效组患者上述指标明显低于治疗前，与无效组比较，有效组的 NIC-A、NIC-V、NCT-A 和 NCT-V 值明显低于无效组（P<0.05）。治疗后，无效组的 NIC-V 和 NCT-V 低于治疗前，差异有统计学意义（P<0.05）。但是，其 NIC-A 和 NCT-A 与治疗前无统计学差异（P>0.05）。
利用 DECT 碘图可以评估食管癌患者 CRT 前后 NIC 和 NIC 的变化，能够评估 CRT 疗效，且不增加辐射剂量，适合临床应用。
