Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany.
Institute of Neuroradiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany.
Curr Oncol. 2023 Jan 23;30(2):1502-1515. doi: 10.3390/curroncol30020115.
Spectral computed tomography (SCT) allows iodine content (IC) calculation for characterization of hypervascularized neoplasms and thus might help in the staging of neuroendocrine tumors (NETs). This single-center prospective study analyzed the association between SCT-derived IC and tumor response in the follow-up of metastasized NETs. Twenty-six patients with a median age of 70 years (range 51-85) with histologically proven NETs and a total of 78 lesions underwent SCT for staging. Because NETS are rare, no primary NET types were excluded. Lesions and intralesional hotspots were measured in virtual images and iodine maps. Tumor response was classified as progressive or nonprogressive at study endpoint. Generalized estimating equations served to estimate associations between IC and tumor response, additionally stratified by lesion location. Most commonly affected sites were the lymph nodes, liver, pancreas, and bones. Median time between SCT and endpoint was 64 weeks (range 5-260). Despite statistical imprecision in the estimate, patients with higher IC in lymphonodular metastases had lower odds for disease progression (adjusted OR = 0.21, 95% CI: 0.02-2.02). Opposite tendencies were observed in hepatic and pancreatic metastases in unadjusted analyses, which vanished after adjusting for therapy and primary tumor grade.
光谱 CT（SCT）可计算碘含量（IC），用于描述富血管性肿瘤，从而有助于神经内分泌肿瘤（NET）的分期。这项单中心前瞻性研究分析了 SCT 衍生的 IC 与转移性 NET 随访中肿瘤反应之间的相关性。26 名年龄中位数为 70 岁（范围 51-85 岁）的经组织学证实的 NET 患者和总共 78 处病变接受了 SCT 分期。由于 NET 罕见，因此没有排除任何原发性 NET 类型。在虚拟图像和碘图上测量病变和瘤内热点。根据研究终点，将肿瘤反应分为进展性或非进展性。广义估计方程用于估计 IC 与肿瘤反应之间的关联，并按病变位置进行分层。最常受影响的部位是淋巴结、肝脏、胰腺和骨骼。SCT 与终点之间的中位时间为 64 周（范围 5-260）。尽管估计值存在统计学不精确，但淋巴结转移中 IC 较高的患者疾病进展的可能性较低（调整后的 OR = 0.21，95%CI：0.02-2.02）。在未调整分析中，肝和胰腺转移中观察到相反的趋势，但在调整治疗和原发肿瘤分级后，这些趋势消失。
