Corrias Giuseppe, Erta Marco, Sini Marcello, Sardu Claudia, Saba Luca, Mahmood Usman, Huicochea Castellanos Sandra, Bates David, Mondanelli Nicola, Thomsen Brian, Carollo Gabriella, Sawan Peter, Mannelli Lorenzo
Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Radiology, University of Cagliari, Italy.
Dose Response. 2021 Apr 20;19(2):1559325820984938. doi: 10.1177/1559325820984938. eCollection 2021 Apr-Jun.
Oncologic patients who develop chemotherapy-associated liver injury (CALI) secondary to chemotherapy treatment tend to have worse outcomes. Biopsy remains the gold standard for the diagnosis of hepatic steatosis. The purpose of this article is to compare 2 alternatives: Proton-Density-Fat-Fraction (PDFF) MRI and MultiMaterial-Decomposition (MMD) DECT.
49 consecutive oncologic patients treated with Chemotherapy underwent abdominal DECT and abdominal MRI within 2 weeks of each other. Two radiologists tracked Regions of Interest independently both in the PDFF fat maps and in the MMD DECT fat maps. Non-parametric exact Wilcoxon signed rank test and Cohen's K were used to compare the 2 sequences and to evaluate the agreement.
There was no statistically significant difference in the fat fraction measured as a continuous value between PDFF and DECT between 2 readers. Within the same imaging method (PDFF) the degree of agreement based on the k coefficient between reader 1 and reader 2 is 0.88 (p-value < 0.05). Similarly, for single-source DECT(ssDECT) the degree of agreement based on the k coefficient between reader 1 and reader 2 is 0.97 (p-value < 0.05).
The results of this study demonstrate that the hepatic fat fraction of ssDECT with MMD are not significantly different from PDFF. This could be an advantage in an oncological population that undergoes serial CT scans for follow up of chemotherapy response.
因化疗治疗而发生化疗相关性肝损伤(CALI)的肿瘤患者往往预后较差。活检仍然是肝脂肪变性诊断的金标准。本文的目的是比较两种替代方法:质子密度脂肪分数(PDFF)磁共振成像(MRI)和多物质分解(MMD)双能CT(DECT)。
49例接受化疗的连续肿瘤患者在彼此相隔2周内分别接受腹部DECT和腹部MRI检查。两名放射科医生分别在PDFF脂肪图和MMD DECT脂肪图中独立追踪感兴趣区域。采用非参数精确威尔科克森符号秩检验和科恩Kappa系数来比较这两种序列并评估一致性。
两位读者测得的PDFF和DECT之间作为连续值的脂肪分数无统计学显著差异。在相同成像方法(PDFF)内,读者1和读者2之间基于Kappa系数的一致性程度为0.88(p值<0.05)。同样,对于单源DECT(ssDECT),读者1和读者2之间基于Kappa系数的一致性程度为0.97(p值<0.05)。
本研究结果表明,采用MMD的ssDECT的肝脏脂肪分数与PDFF无显著差异。这对于因化疗反应随访而接受系列CT扫描的肿瘤患者群体可能是一个优势。