Chima Ranjit S, Glushko Tetiana, Park Margaret A, Hodul Pamela, Davis Evan W, Martin Katelyn, Qayyum Aliya, Permuth Jennifer B, Jeong Daniel
Department of Diagnostic Imaging and Interventional Radiology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center & Research Institute, 12902 USF Magnolia Drive, Tampa, FL 33612, USA.
Diagnostics (Basel). 2024 Nov 18;14(22):2593. doi: 10.3390/diagnostics14222593.
The effect of differing post-contrast phases on CT body composition measurements is not yet known.
A fully automated AI-based body composition analysis using DAFS was performed on a retrospective cohort of 278 subjects undergoing pre-treatment triple-phase CT for pancreatic intraductal papillary mucinous neoplasm. The CT contrast phases included noncontrast (NON), arterial (ART), and venous (VEN) phases. The software selected a single axial CT image at mid-L3 on each phase for body compartment segmentation. The areas (cm) were calculated for skeletal muscle (SM), intermuscular adipose tissue (IMAT), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT). The mean Hounsfield units of skeletal muscle (SMHU) within the segmented regions were calculated. Bland-Altman and Chi Square analyses were performed.
SM-NON had a lower percentage of bias [LOA] than SM-ART, -0.7 [-7.6, 6.2], and SM-VEN, -0.3 [-7.6, 7.0]; VAT-NON had a higher percentage of bias than ART, 3.4 [-18.2, 25.0], and VEN, 5.8 [-15.0, 26.6]; and this value was lower for SAT-NON than ART, -0.4 [-14.9, 14.2], and VEN, -0.5 [-14.3, 13.4]; and higher for IMAT-NON than ART, 5.9 [-17.9, 29.7], and VEN, 9.5 [-17.0, 36.1]. The bias in SMHU NON [LOA] was lower than that in ART, -3.8 HU [-9.8, 2.1], and VEN, -7.8 HU [-14.8, -0.8].
IV contrast affects the voxel HU of fat and muscle, impacting CT analysis of body composition. We noted a relatively smaller bias in the SM, VAT, and SAT areas across the contrast phases. However, SMHU and IMAT experienced larger bias. During threshold risk stratification for CT-based measurements of SMHU and IMAT, the IV contrast phase should be taken into consideration.
不同的增强后阶段对CT人体成分测量的影响尚不清楚。
对278例接受胰腺导管内乳头状黏液性肿瘤治疗前三相CT检查的受试者进行回顾性队列研究，采用基于人工智能的全自动DAFS人体成分分析。CT增强阶段包括平扫（NON）、动脉期（ART）和静脉期（VEN）。软件在每个阶段的L3中部选择一张轴向CT图像进行身体腔室分割。计算骨骼肌（SM）、肌间脂肪组织（IMAT）、内脏脂肪组织（VAT）和皮下脂肪组织（SAT）的面积（cm）。计算分割区域内骨骼肌的平均亨氏单位（SMHU）。进行布兰德-奥特曼分析和卡方分析。
SM-NON的偏差百分比[LOA]低于SM-ART，为-0.7[-7.6,6.2]，以及SM-VEN，为-0.3[-7.6,7.0]；VAT-NON的偏差百分比高于ART，为3.4[-18.2,25.0]，以及VEN，为5.8[-15.0,26.6]；SAT-NON的该值低于ART，为-0.4[-14.9,14.2]，以及VEN，为-0.5[-14.3,13.4]；IMAT-NON的该值高于ART，为5.9[-17.9,29.7]，以及VEN，为9.5[-17.0,36.1]。SMHU NON[LOA]的偏差低于ART，为-3.8 HU[-9.8,2.1]，以及VEN，为-7.8 HU[-14.8,-0.8]。
静脉注射造影剂会影响脂肪和肌肉的体素HU，影响人体成分的CT分析。我们注意到在不同增强阶段，SM、VAT和SAT区域的偏差相对较小。然而，SMHU和IMAT的偏差较大。在基于CT测量SMHU和IMAT的阈值风险分层过程中，应考虑静脉注射造影剂的阶段。
