Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, ROC.
Ph.D. Program of Electrical and Communications Engineering, Feng Chia University, Taichung, Taiwan, ROC.
Sci Rep. 2024 Mar 4;14(1):5310. doi: 10.1038/s41598-024-55427-5.
Our study aimed to compare bone scintigraphy and dual-layer detector spectral CT (DLCT) with multiphase contrast enhancement for the diagnosis of osteoblastic bone lesions in patients with prostate cancer. The patients with prostate cancer and osteoblastic bone lesions detected on DLCT were divided into positive bone scintigraphy group (pBS) and negative bone scintigraphy group (nBS) based on bone scintigraphy. A total of 106 patients (57 nBS and 49 pBS) was included. The parameters of each lesion were measured from DLCT including Hounsfield unit (HU), 40-140 keV monochromatic HU, effective nuclear numbers (Z), and Iodine no water (InW) value in non-contrast phase (N), the arterial phase (A), and venous phase (V). The slope of the spectral curve at 40 and 100 keV, the different values of the parameters between A and N phase (A-N), V and N phase (V-N), and hybrid prediction model with multiparameters were used to differentiate pBS from nBS. Receiver operating characteristic analysis was performed to compare the area under the curve (AUC) for differentiating the pBS group from the nBS group. The value of conventional HU values, slope, and InW in A-N and V-N, and hybrid model were significantly higher in the pBS group than in the nBS group. The hybrid model of all significant parameters had the highest AUC of 0.988, with 95.5% sensitivity and 94.6% specificity. DLCT with arterial contrast enhancement phase has the potential to serve as an opportunistic screening tool for detecting positive osteoblastic bone lesions, corresponding to those identified in bone scintigraphy.
本研究旨在比较骨闪烁显像和双层探测器能谱 CT（DLCT）与多期增强对比对前列腺癌患者成骨性骨病变的诊断价值。根据骨闪烁显像将 DLCT 检测到的前列腺癌和成骨性骨病变患者分为阳性骨闪烁显像组（pBS）和阴性骨闪烁显像组（nBS）。共纳入 106 例患者（57 例 nBS 和 49 例 pBS）。从 DLCT 测量每个病变的参数，包括 CT 值、40-140keV 单能 CT 值、有效原子序数（Z）和非对比期（N）、动脉期（A）和静脉期（V）碘水值（InW）。在 40keV 和 100keV 时的光谱曲线斜率，A 期和 N 期（A-N）、V 期和 N 期（V-N）之间的参数差值，以及多参数混合预测模型，用于区分 pBS 和 nBS。进行受试者工作特征分析比较曲线下面积（AUC）以区分 pBS 组和 nBS 组。pBS 组的常规 CT 值、斜率和 A-N、V-N 期 InW 值以及混合模型的值均显著高于 nBS 组。所有显著参数的混合模型的 AUC 最高为 0.988，灵敏度为 95.5%，特异度为 94.6%。动脉期增强的 DLCT 有潜力作为一种机会性筛查工具，用于检测阳性成骨性骨病变，与骨闪烁显像结果相对应。
