Perfusion-CT monitoring of cryo-ablated renal cells tumors.
Perfusion-CT monitoring of cryo-ablated renal cells tumors.
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DOI：
10.1186/1756-9966-28-138
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发表时间：
2009-10-10
期刊：
影响因子：
--
通讯作者：
Simonetti G
中科院分区：
文献类型：
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作者：
Squillaci E;Manenti G;Cicciò C;Nucera F;Bove P;Vespasiani G;Russolillo L;Simonetti G
没有单一的和彻底验证的成像方法在监测冷冻消融肾细胞癌（RCC）是可用的。本研究的目的是确定动态增强CT灌注成像（pCT）评价肾细胞癌血流动力学反应的可行性。15名患者（14名男性，1名女性;年龄范围，43-81岁;平均年龄，62岁）通过腹膜途径进行冷冻消融RCC，在冷冻治疗后6-8个月接受pCT。在静脉注射造影剂（80 mL，370 mg碘/mL，4 mL/sec）后进行pCT 65秒。使用基于去卷积的方法在冷冻消融的肿瘤区域和同侧肾皮质中采集灌注参数（时间/密度曲线;血流量，BF;血容量，BV;平均通过时间，MTT;渗透性-表面积乘积，PS）。与术前CT对照相比，通过冷冻消融区域病理性对比增强或肾脏肿块持续存在的CT证据，认为肿瘤对治疗无反应。在研究前获得所有参与者的书面知情同意书。冷冻治疗后，成功消融的肿瘤（n = 13）显示BV降低（5.39 +/-1.28 mL/100 g），BF（69.92 +/-20.12 mL/100 g/min）和PS（16，66 +/-5，67 mL/100 g/min）值和MTT增加值（25，35 +/-4，3秒）与正常肾皮质相比（BV：117.86 +/-31.87 mL/100 g/min; BF：392.39 +/-117.32 mL/100 g/min; MTT：18.02 +/-3.6 sec; PS：81.68 +/-22.75 mL/100 g/min）。在1例患者中，灌注参数的评估对于呼吸伪影是不可行的。一个肿瘤显示治疗反应不佳的证据结节对比增强的区域包括原来的病变。比较有反应和无反应消融肿瘤的时间-密度曲线，得到两种典型的增强模式。灌注CT是一种可行的、有前途的冷冻消融治疗效果监测技术。
No single and thoroughly validated imaging method in monitoring of cryoablated renal cell carcinoma (RCC) is available. The purpose of our study was to determine the feasibility of dynamic contrast-enhanced perfusion CT (pCT) in evaluating the hemodynamic response of RCC. 15 patients (14 male, 1 female; age range, 43-81 years; mean age, 62 years) with cryoablated RCC via a transperitoneal approach, underwent to pCT 6-8 months after cryo-therapy. pCT was performed for 65 seconds after intravenous injection of contrast medium (80 mL, 370 mg iodine per millilitre, 4 mL/sec). Perfusion parameters (Time/Density curve; Blood flow, BF; Blood Volume, BV; Mean Transit Time, MTT; Permeability-Surface Area Product, PS) were sampled in the cryoablated tumor area and in ipsilateral renal cortex using deconvolution-based method. A tumor was considered to be not responsive to treatment by CT evidence of pathological contrast enhancement in the cryoablated area or renal mass persistence compared with the preoperative CT control. Written informed consent was obtained from all participants before the study. After cryotherapy, successfully ablated tumor (n = 13) showed decrease in BV (5,39 +/- 1,28 mL/100 g), BF (69,92 +/- 20,12 mL/100 g/min) and PS (16,66 +/- 5,67 mL/100 g/min) value and increased value of MTT (25,35 +/- 4,3 sec) compared with those of normal renal cortex (BV: 117,86 +/- 31,87 mL/100 g/min; BF: 392,39 +/- 117,32 mL/100 g/min; MTT: 18,02 +/- 3,6 sec; PS: 81,68 +/- 22,75 mL/100 g/min). In one patient, assessment of perfusion parameters was not feasible for breathing artifacts. One tumor showed poor response to treatment by the evidence of nodular contrast enhancement in the region encompassing the original lesion. Two typical enhancement patterns were obtained comparing the Time-Density curves of responsive and not responsive ablated tumors. Perfusion CT seems to be a feasible and promising technique in monitoring the effects of cryoablation therapy.