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容积 CT 灌注作为预测宫颈癌同步放化疗治疗反应的标志物:一项前瞻性研究。

Volume computed tomography perfusion as a predictive marker for treatment response to concurrent chemoradiotherapy in cervical cancer: a prospective study.

机构信息

Department of Radiology, Cancer Hospital of China Medical University, LiaoNing Cancer Hospital & Institute, Shenyang, Liaoning, PR China.

出版信息

Acta Radiol. 2021 Feb;62(2):281-288. doi: 10.1177/0284185120919261. Epub 2020 Jun 17.

Abstract

BACKGROUND

Computed tomography perfusion (CTP) can provide information on blood perfusion as a reliable marker of tumor response to therapy.

PURPOSE

To assess the role of volume CTP (vCTP) parameters in predicting treatment response to concurrent chemoradiotherapy (CCRT) for cervical cancer.

MATERIAL AND METHODS

Thirty-three patients with cervical cancer underwent vCTP. Three CTP parameters of cervical cancer-including arterial flow (AF), blood volume (BV), and permeability surface (PS)-were measured in two different ways: the region of interest incorporating the "local hot" with the highest enhancement and "cold spot" with the lowest enhancement; and "whole-tumor" measurements. The patients were divided into non-residual and residual tumor groups according to the short-term response to treatment. The clinical and perfusion parameters were compared between the two groups.

RESULTS

There was no significant difference in age, body mass index, FIGO stage, pathological grade, or pretreatment tumor size between the two groups ( > 0.05). The non-residual tumor group had higher pretreatment AF in high-perfusion and low-perfusion subregions than the residual tumor group ( <0.05), but the AF in whole-tumor regions was not different between the two groups ( > 0.05). There were no differences in BV and PS between the two groups ( > 0.05). The diagnostic potency of AF in the low-perfusion subregion was higher than that in the high-perfusion subregion.

CONCLUSION

vCTP parameters are valuable for the prediction of short-term effects. The AF in the low-perfusion subregion was a more effective index for predicting treatment response to CCRT of cervical cancer.

摘要

背景

计算机断层灌注 (CTP) 可以提供血流灌注信息,作为肿瘤对治疗反应的可靠标志物。

目的

评估体积 CTP (vCTP) 参数在预测宫颈癌同步放化疗 (CCRT) 治疗反应中的作用。

材料与方法

33 例宫颈癌患者行 vCTP 检查。两种方法测量宫颈癌的 CTP 参数:感兴趣区(ROI)包括增强程度最高的“局部热点”和最低的“冷点”;以及“全肿瘤”测量。根据治疗后的短期反应将患者分为非残留肿瘤组和残留肿瘤组。比较两组之间的临床和灌注参数。

结果

两组间年龄、体重指数、FIGO 分期、病理分级或预处理肿瘤大小无显著差异(>0.05)。非残留肿瘤组高灌注和低灌注亚区的预处理 AF 高于残留肿瘤组(<0.05),但全肿瘤区域的 AF 无差异(>0.05)。两组间 BV 和 PS 无差异(>0.05)。低灌注亚区的 AF 诊断效能高于高灌注亚区。

结论

vCTP 参数对短期疗效预测有价值。低灌注亚区的 AF 是预测宫颈癌 CCRT 治疗反应的更有效指标。

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