Department of Radiology, Meizhou People's Hospital, Meizhou, 514000, Guangdong, China.
BMC Med Imaging. 2024 Aug 12;24(1):212. doi: 10.1186/s12880-024-01393-3.
Prostate cancer is one of the most common malignant tumors in middle-aged and elderly men and carries significant prognostic implications, and recent studies suggest that dual-energy computed tomography (DECT) utilizing new virtual monoenergetic images can enhance cancer detection rates. This study aimed to assess the impact of virtual monoenergetic images reconstructed from DECT arterial phase scans on the image quality of prostate lesions and their diagnostic performance for prostate cancer.
We conducted a retrospective analysis of 83 patients with prostate cancer or prostatic hyperplasia who underwent DECT scans at Meizhou People's Hospital between July 2019 and December 2023. The variables analyzed included age, tumor diameter and serum prostate-specific antigen (PSA) levels, among others. We also compared CT values, signal-to-noise ratio (SNR), subjective image quality ratings, and contrast-to-noise ratio (CNR) between virtual monoenergetic images (40-100 keV) and conventional linear blending images. Receiver operating characteristic (ROC) curve analyses were performed to evaluate the diagnostic efficacy of virtual monoenergetic images (40 keV and 50 keV) compared to conventional images.
Virtual monoenergetic images at 40 keV showed significantly higher CT values (168.19 ± 57.14) compared to conventional linear blending images (66.66 ± 15.5) for prostate cancer (P < 0.001). The 50 keV images also demonstrated elevated CT values (121.73 ± 39.21) compared to conventional images (P < 0.001). CNR values for the 40 keV (3.81 ± 2.13) and 50 keV (2.95 ± 1.50) groups were significantly higher than the conventional blending group (P < 0.001). Subjective evaluations indicated markedly better image quality scores for 40 keV (median score of 5) and 50 keV (median score of 5) images compared to conventional images (P < 0.05). ROC curve analysis revealed superior diagnostic accuracy for 40 keV (AUC: 0.910) and 50 keV (AUC: 0.910) images based on CT values compared to conventional images (AUC: 0.849).
Virtual monoenergetic images reconstructed at 40 keV and 50 keV from DECT arterial phase scans substantially enhance the image quality of prostate lesions and improve diagnostic efficacy for prostate cancer.
前列腺癌是中老年男性中最常见的恶性肿瘤之一，具有重要的预后意义，最近的研究表明，利用新的虚拟单能量图像的双能 CT（DECT）可以提高癌症检出率。本研究旨在评估 DECT 动脉期扫描重建的虚拟单能量图像对前列腺病变的图像质量及其对前列腺癌的诊断性能的影响。
我们对 2019 年 7 月至 2023 年 12 月在梅州市人民医院接受 DECT 扫描的 83 例前列腺癌或前列腺增生患者进行了回顾性分析。分析的变量包括年龄、肿瘤直径和血清前列腺特异性抗原（PSA）水平等。我们还比较了虚拟单能量图像（40-100keV）和常规线性混合图像之间的 CT 值、信噪比（SNR）、主观图像质量评分和对比噪声比（CNR）。进行了受试者工作特征（ROC）曲线分析，以评估虚拟单能量图像（40keV 和 50keV）与常规图像相比的诊断效果。
对于前列腺癌，虚拟单能量图像在 40keV 时的 CT 值（168.19±57.14）明显高于常规线性混合图像（66.66±15.5）（P<0.001）。50keV 图像的 CT 值（121.73±39.21）也高于常规图像（P<0.001）。40keV（3.81±2.13）和 50keV（2.95±1.50）组的 CNR 值明显高于常规混合组（P<0.001）。主观评价表明，40keV（中位数评分为 5）和 50keV（中位数评分为 5）图像的图像质量评分明显优于常规图像（P<0.05）。ROC 曲线分析显示，基于 CT 值，40keV（AUC：0.910）和 50keV（AUC：0.910）图像的诊断准确性优于常规图像（AUC：0.849）。
从 DECT 动脉期扫描重建的 40keV 和 50keV 虚拟单能量图像显著提高了前列腺病变的图像质量，并提高了前列腺癌的诊断效果。
