Ning Hou-Fa, Qin Yun-Long, Yue Kui-Tao, Wang Shuai, Shao Wei-Guang, Wang Guang-Zhi
Department of Medical Imaging Center, Affiliated Hospital of Shandong Second Medical University, Weifang, Shandong, China.
Department of Radiology, School of Medical Imaging, Shandong Second Medical University, Weifang, Shandong, China.
J Res Med Sci. 2024 Dec 31;29:76. doi: 10.4103/jrms.jrms_630_23. eCollection 2024.
Accurate and timely assessment of tumor response after chemotherapy is crucial in clinical settings. The aim of this study was to explore the feasibility of Gemstone Spectral Imaging (GSI) for early assessment of chemotherapy responses in patients with colorectal cancer liver metastasis (CRCLM).
From October 2012 to October 2018, 46 patients (28 males and 18 females) with CRCLM received GSI followed by chemotherapy were retrospectively reviewed. The patients were divided into a response group ( = 32) and a nonresponse group ( = 14) according to the tumor response to chemotherapy. The iodine concentration images and virtual monoenergetic images (VMIs) with an optimal contrast-to-noise ratio at the arterial phase (AP) and portal venous phase (PVP) were obtained by GSI viewer. The iodine concentration value and computed tomography (CT) value on VMIs and slope of spectral attenuation curves of all lesions were compared. A logistic regression analysis was used to determine the predictor of chemotherapy response.
The difference of extrahepatic metastasis ( = 0.001), CT value on 68 keV VMIs at the AP ( = 0.005) and PVP ( = 0.001), slope of CT value attenuation curves at the AP ( = 0.013) and PVP ( = 0.001), and iodine concentration value at PVP ( = 0.003) between the response and nonresponse groups were statistically significant. The CT value of the 68 keV VMIs (OR: 1.206; 95% confidence interval [CI]: 1.021-1.425, = 0.027) and the iodine concentration value at PVP (OR: 1.952; 95% CI: 1.034-3.684, = 0.039) were independent prognostic factors for predicting chemotherapy response.
Baseline GSI may help predict the response to chemotherapy and provide a good tumor-response indicator through single-energy CT value of 68 keV at the PVP and iodine concentration.
在临床环境中，准确及时地评估化疗后肿瘤反应至关重要。本研究的目的是探讨宝石能谱成像（GSI）在结直肠癌肝转移（CRCLM）患者化疗反应早期评估中的可行性。
回顾性分析2012年10月至2018年10月期间46例接受GSI检查后进行化疗的CRCLM患者（男28例，女18例）。根据化疗后的肿瘤反应将患者分为反应组（n = 32）和无反应组（n = 14）。通过GSI观察软件获得动脉期（AP）和门静脉期（PVP）具有最佳对比噪声比的碘浓度图像和虚拟单能量图像（VMIs）。比较所有病灶在VMIs上碘浓度值、CT值以及光谱衰减曲线斜率。采用逻辑回归分析确定化疗反应的预测指标。
反应组与无反应组在肝外转移（P = 0.001）、AP期（P = 0.005）和PVP期（P = 0.001）68 keV VMIs上的CT值、AP期（P = 0.013）和PVP期（P = 0.001）CT值衰减曲线斜率以及PVP期碘浓度值（P = 0.003）方面的差异具有统计学意义。68 keV VMIs的CT值（OR：1.206；95%置信区间[CI]：1.021 - 1.425，P = 0.027）和PVP期碘浓度值（OR：1.952；95% CI：1.034 - 3.684，P = 0.039）是预测化疗反应的独立预后因素。
基线GSI可能有助于预测化疗反应，并通过PVP期68 keV单能量CT值和碘浓度提供良好的肿瘤反应指标。
