Elsherif S B, Zheng S, Ganeshan D, Iyer R, Wei W, Bhosale P R
Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Houston, TX 77030, USA.
Department of Diagnostic and Interventional Imaging, The University of Texas Health Science Center at Houston McGovern Medical School, MSB 2.130B, 6431 Fannin Street, Houston, TX 77030 Houston, Texas, USA.
Clin Radiol. 2020 Aug;75(8):606-614. doi: 10.1016/j.crad.2020.03.006. Epub 2020 Apr 4.
To assess the ability of dual-energy computed tomography (DECT) to distinguish benign from malignant ovarian tumours (OTs).
Following approval of the institutional review board, the institutional database was mined for treatment-naive patients who underwent primary cytoreduction for OT. Thirty-seven patients were included and divided into those with benign OTs (n = 11) and malignant OTs (n = 26), including high-grade (n = 20) and low-grade (n = 6) malignant OTs. Advanced processing and region of interest delineation on the ovarian mass were performed using the preoperative staging DECT examination using the Advantage Workstation. The pixel-level data of the CT attenuation values at 50, 70, and 120 keV and the effective atomic number (Z), water content (WC), and iodine content (IC) in the ovarian mass were recorded. The Wilcoxon rank-sum test was used to compare CT attenuation data at different voltages, Z, and WC and IC levels between benign and malignant OTs and between high- and low-grade malignant OTs. Simple logistic regression was used to correlate the imaging characteristics with malignant status and grade.
Malignant OTs had significantly higher Z and IC compared with benign OTs. The threshold values for the diagnosis of malignant OT were IC≥9.74 (100 μg/cm) with 81% sensitivity and 73% specificity and Z ≥8.16 with 85% sensitivity and 73% specificity. High-grade OTs had significantly higher WC compared with low-grade OTs, and a threshold of ≥1,013.92 mg/cm differentiated them with 80% sensitivity and 83% specificity.
DECT may be a tool to help distinguish malignant and benign OTs and predict tumour grade.
评估双能计算机断层扫描（DECT）区分卵巢良性肿瘤与恶性肿瘤（OTs）的能力。
经机构审查委员会批准后，在机构数据库中筛选出未经治疗且因OT接受初次肿瘤细胞减灭术的患者。纳入37例患者，分为良性OT组（n = 11）和恶性OT组（n = 26），其中恶性OT组包括高级别（n = 20）和低级别（n = 6）恶性OT。使用Advantage Workstation对术前分期DECT检查的卵巢肿块进行高级处理和感兴趣区勾画。记录卵巢肿块在50、70和120 keV时的CT衰减值像素级数据以及有效原子序数（Z）、含水量（WC）和碘含量（IC）。采用Wilcoxon秩和检验比较良性与恶性OT之间以及高级别与低级别恶性OT之间不同电压、Z、WC和IC水平的CT衰减数据。采用简单逻辑回归分析成像特征与恶性状态及分级的相关性。
与良性OT相比，恶性OT的Z和IC显著更高。诊断恶性OT的阈值为IC≥9.74（100μg/cm），灵敏度为81%，特异度为73%；Z≥8.16，灵敏度为85%，特异度为73%。与低级别OT相比，高级别OT的WC显著更高，阈值≥1,013.92mg/cm对二者的区分灵敏度为80%，特异度为83%。
DECT可能是一种有助于区分卵巢良恶性肿瘤并预测肿瘤分级的工具。
