Gaur Sonia, Stein Erica B, Schneider Daniel K, Masotti Maria, Davenport Matthew S, George Arvin K, Ellis James H
Department of Radiology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI, 48109-5030, USA.
Department of Biostatistics, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI, 48109-2029, USA.
Abdom Radiol (NY). 2024 Jun;49(6):1929-1939. doi: 10.1007/s00261-024-04184-0. Epub 2024 Feb 20.
Gold-silica nanoshell therapy [AuroShells with subsequent focal laser therapy (AuroLase)] is an emerging targeted treatment modality for prostate cancer. We reviewed pre- and post-treatment unenhanced CT imaging to assess for retained gold-silica nanoshells in the abdomen and pelvis.
This single-institution retrospective study identified patients in the AuroLase pilot who underwent pre- and post-treatment unenhanced abdominopelvic CT. The attenuation, before and after gold-silica nanoshell administration, of the liver, spleen, pancreas, kidneys, prostate, blood pool, paraspinal musculature, and abnormal lymph nodes were manually measured by two readers. After inter-reader agreement was calculated using intraclass correlation (ICC), a permutation test was used to assess pre- and post-therapy attenuation differences.
Four patients met the inclusion criteria. Mean age was 72.3 ± 5.9 years. Median time interval between pre-treatment CT and treatment, and between treatment and post-treatment CT, was 232 days and 236.5 days, respectively. The two readers' attenuation measurements had very high agreement (ICC = 0.99, p < 0.001). The highest differences in organ attenuation between pre- and post-therapy scans were seen in all four patients in the liver and spleen (liver increased by an average of 28.9 HU, p = 0.010; spleen increased by an average of 63.7 HU, p = 0.012). A single measured lymph node increased by an average of 58.9 HU. In the remainder of the measured sites, the change in attenuation from pre- to post-therapy scans ranged from -0.1 to 3.8 HU (p > 0.05).
Increased attenuation of liver and spleen at CT can be an expected finding in patients who have received gold-silica nanoshell therapy.
金硅纳米壳治疗（随后进行聚焦激光治疗的金壳[AuroLase]）是一种新兴的前列腺癌靶向治疗方式。我们回顾了治疗前和治疗后的平扫CT影像，以评估腹部和盆腔中留存的金硅纳米壳。
这项单机构回顾性研究纳入了接受过治疗前和治疗后腹部盆腔平扫CT的AuroLase试验患者。由两名阅片者手动测量金硅纳米壳给药前后肝脏、脾脏、胰腺、肾脏、前列腺、血池、椎旁肌肉组织及异常淋巴结的衰减值。在使用组内相关系数（ICC）计算阅片者间一致性后，采用置换检验评估治疗前后的衰减差异。
4例患者符合纳入标准。平均年龄为72.3±5.9岁。治疗前CT与治疗之间以及治疗与治疗后CT之间的中位时间间隔分别为232天和236.5天。两名阅片者的衰减测量结果具有很高的一致性（ICC = 0.99，p < 0.001）。治疗前后扫描中，所有4例患者肝脏和脾脏的器官衰减差异最大（肝脏平均增加28.9 HU，p = 0.010；脾脏平均增加63.7 HU，p = 0.012）。单个测量的淋巴结平均增加58.9 HU。在其余测量部位，治疗前后扫描的衰减变化范围为-0.1至3.8 HU（p > 0.05）。
接受金硅纳米壳治疗的患者，CT上肝脏和脾脏衰减增加可能是预期表现。
