Xu Fengming, Tang Cheng, Huang Yiling, Liang Linlin, Huang Fuling, Yang Gaohui, Peng Peng
Department of Radiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, 530021, Guangxi Zhuang Autonomous Region, China.
NHC Key Laboratory of Thalassemia Medicine (Guangxi Medical University), Guangxi Zhuang Autonomous Region, People's Republic of China.
Mediterr J Hematol Infect Dis. 2023 Mar 1;15(1):e2023020. doi: 10.4084/MJHID.2023.020. eCollection 2023.
To explore the feasibility and accuracy of liver iron deposition based on dual-energy CT in thalassemia patients.
105 thalassemia patients were examined with dual-energy CT and MR liver scanning. Dual-energy CT was performed to measure CT values on 80kVp, 140kVp, and virtual iron content (VIC) imaging; ΔH was figured out by the difference in CT values between 80kVp and 140kVp. Using the liver iron concentration (LIC) obtained by FerriScan as a gold standard, the correlation between CT measurements and LIC was evaluated. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance for dual-energy CT in liver iron quantification and stratification.
The correlation analysis between CT measurements and LIC showed that 80kVp, 140kVp, VIC, and ΔH all had a high positive correlation with LIC (<0.001). The correlation analysis among different degree groups of VIC, ΔH, and LIC showed that the normal, moderate, and severe groups of VIC and ΔH had moderate or high positive correlations with that of LIC (<0.01), but the mild group had no correlation (>0.05). ROC analysis revealed that the corresponding optimal cutoff value of VIC was -2.8, 6.3,11.9 HU (corresponds to 3.2,7.0,15.0 mg/g dry weight) respectively, while the ΔH were 5.1, 8.4, 17.8HU, respectively. The area under the receiver operating characteristic curves (AUCs) for both VIC and ΔH increased with LIC thresholds.
Dual-energy CT can accurately quantify and stratify liver iron deposition, contributing to predicting the status of liver iron deposition in thalassemia patients.
探讨基于双能量CT评估地中海贫血患者肝脏铁沉积的可行性及准确性。
对105例地中海贫血患者进行双能量CT及肝脏磁共振扫描。采用双能量CT测量80kVp、140kVp时的CT值及虚拟铁含量(VIC)成像;通过80kVp与140kVp时CT值的差值计算ΔH。以FerriScan获得的肝脏铁浓度(LIC)作为金标准,评估CT测量值与LIC之间的相关性。采用受试者操作特征(ROC)分析评估双能量CT在肝脏铁定量及分层诊断中的性能。
CT测量值与LIC的相关性分析显示,80kVp、140kVp、VIC及ΔH与LIC均呈高度正相关(<0.001)。VIC、ΔH与LIC不同程度组间的相关性分析显示,VIC及ΔH的正常、中度及重度组与LIC呈中度或高度正相关(<0.01),而轻度组无相关性(>0.05)。ROC分析显示,VIC对应的最佳截断值分别为-2.8、6.3、11.9 HU(分别对应干重3.2、7.0、15.0 mg/g),而ΔH分别为5.1、8.4、17.8 HU。VIC和ΔH的受试者操作特征曲线下面积(AUC)均随LIC阈值增加。
双能量CT可准确量化和分层肝脏铁沉积,有助于预测地中海贫血患者肝脏铁沉积状态。