All authors: Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
AJR Am J Roentgenol. 2020 Apr;214(4):808-816. doi: 10.2214/AJR.19.21969. Epub 2020 Feb 18.
The purpose of this study is to determine the degree of the relationship between perfusion CT (PCT) parameters and iodine concentration metrics derived from triple-bolus dual-energy CT (DECT) and to compare the radiation dose delivered. This single-center prospective study was conducted from October 2015 to September 2017. Twenty-three consenting adults (15 men and eight women; mean [± SD] age, 56 ± 13 years [range, 25-78 years]) with renal cell carcinomas underwent consecutive PCT and triple-bolus DECT examinations. Triple-bolus DECT consisted of synchronous corticomedullary, nephrographic, and delayed phase scans acquired using a dual-source DECT scanner. Two readers independently analyzed blood flow, blood volume, and permeability, as measured by PCT, and iodine density and iodine ratio, as measured by triple-bolus DECT. Size-specific dose estimates were calculated for both groups. Interreader agreement was good for permeability (intraclass correlation coefficient [ICC] =.812) and blood flow (ICC = 0.849) and excellent for blood volume (ICC = 0.956), iodine density (ICC = 0.961), and iodine ratio (ICC = 0.956). Very strong positive correlations were found between blood volume and iodine density ( < 0.001) and between blood volume and iodine ratio ( < 0.001). Strong positive correlations were found between blood flow and iodine density ( < 0.001) and between blood flow and iodine ratio ( < 0.001). The correlations between permeability and iodine density ( = 0.01) and between permeability and iodine ratio ( = 0.02) were moderate. The mean size-specific dose estimate of triple-bolus DECT was approximately 15 times lower than that of PCT ( < 0.001). Quantitative iodine metrics derived from triple-bolus DECT showed significant correlation with CT parameters in renal cell carcinoma, with a significantly lower radiation dose.
本研究旨在确定灌注 CT (PCT) 参数与三重双能量 CT (DECT) 衍生碘浓度指标之间的相关性程度，并比较所传递的辐射剂量。这项单中心前瞻性研究于 2015 年 10 月至 2017 年 9 月进行。23 名同意的成年患者（15 名男性和 8 名女性；平均年龄[±标准差]为 56 ± 13 岁[范围，25-78 岁]）患有肾细胞癌，进行了连续的 PCT 和三重双能量 CT 检查。三重双能量 CT 包括使用双源双能 CT 扫描仪采集同步皮质髓质、肾图和延迟期扫描。两位读者独立分析了 PCT 测量的血流量、血容量和通透性，以及三重双能量 CT 测量的碘密度和碘比。为两组计算了大小特异性剂量估计值。通透性的读者间一致性良好（组内相关系数[ICC] =.812），血流量的读者间一致性良好（ICC = 0.849），血容量的读者间一致性极好（ICC = 0.956），碘密度的读者间一致性极好（ICC = 0.961），碘比的读者间一致性极好（ICC = 0.956）。发现血容量与碘密度之间存在非常强的正相关性（<0.001），血容量与碘比之间存在非常强的正相关性（<0.001）。血流与碘密度之间存在很强的正相关性（<0.001），血流与碘比之间存在很强的正相关性（<0.001）。通透性与碘密度之间的相关性（= 0.01）和通透性与碘比之间的相关性（= 0.02）为中度。三重双能量 CT 的平均大小特异性剂量估计值约为 PCT 的 15 倍（<0.001）。三重双能量 CT 衍生的定量碘指标与肾细胞癌的 CT 参数具有显著相关性，且辐射剂量显著降低。
