Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Institute of Radiation Medicine, Seoul National University Hospital, Seoul, Korea.
Korean J Radiol. 2019 May;20(5):781-790. doi: 10.3348/kjr.2018.0273.
To assess the relationship between contrast-enhanced ultrasound (CEUS) parameters and perfusion CT (PCT) parameters of gastric cancers and their correlation with histologic features.
This prospective study was approved by our Institutional Review Board. We included 43 patients with pathologically-proven gastric cancers undergoing CEUS using SonoVue® (Bracco) and PCT on the same day. Correlation between the CEUS parameters (peak intensity [PI], area under the curve [AUC], rise time [RT] from 10% to 90% of PI, time to peak [TTP], and mean transit time [MTT]) and PCT parameters (blood flow, blood volume, TTP, MTT, and permeability surface product) of gastric cancers were analyzed using Spearman's rank correlation test. In cases of surgical resection, the CEUS and PCT parameters were compared according to histologic features using Mann-Whitney test.
CEUS studies were of diagnostic quality in 88.4% (38/43) of patients. Among the CEUS parameters of gastric cancers, RT and TTP showed significant positive correlations with TTP (rho = 0.327 and 0.374, = 0.045 and 0.021, respectively); PI and AUC were significantly higher in well-differentiated or moderately-differentiated tumors (n = 4) than poorly-differentiated tumors (n = 18) ( = 0.026 and 0.033, respectively), whereas MTT showed significant differences according to histologic types (poorly cohesive carcinoma [PCC] vs. non-PCC), T-staging (≤ T2 vs. ≥ T3), N-staging (N0 vs. N-positive), and epidermal growth factor receptor expression (≤ faint vs. ≥ moderate staining) ( values < 0.05).
In patients with gastric cancers, CEUS is technically feasible for the quantification of tumor perfusion and may provide correlative and complementary information to that of PCT, which may allow prediction of histologic features.
评估胃腺癌的超声造影（CEUS）参数与灌注 CT（PCT）参数之间的关系及其与组织学特征的相关性。
本前瞻性研究获得了我院伦理委员会的批准。我们纳入了 43 例经病理证实的胃腺癌患者，这些患者均于同一天接受 SonoVue®（Bracco）CEUS 和 PCT 检查。采用 Spearman 秩相关检验分析胃腺癌的 CEUS 参数（峰值强度[PI]、曲线下面积[AUC]、PI 从 10%升至 90%的上升时间[RT]、达峰时间[TTP]和平均渡越时间[MTT]）与 PCT 参数（血流、血容量、TTP、MTT 和通透性表面积乘积）之间的相关性。在接受手术切除的病例中，采用 Mann-Whitney 检验比较了根据组织学特征的 CEUS 和 PCT 参数。
88.4%（38/43）的患者 CEUS 检查质量良好。胃腺癌的 CEUS 参数中，RT 和 TTP 与 TTP 呈显著正相关（rho = 0.327 和 0.374， = 0.045 和 0.021）；PI 和 AUC 在分化良好或中等分化肿瘤（n = 4）中显著高于低分化肿瘤（n = 18）（ = 0.026 和 0.033），而 MTT 则根据组织学类型（非黏附性癌[PCC]与非-PCC）、T 分期（≤ T2 与≥ T3）、N 分期（N0 与 N 阳性）和表皮生长因子受体表达（≤弱染色与≥中度染色）存在显著差异（ 值 < 0.05）。
在胃腺癌患者中，CEUS 技术上可行，可用于量化肿瘤灌注，可能为 PCT 提供相关和补充信息，有助于预测组织学特征。
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