Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation
Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation
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DOI：
10.1259/bjr.20150224
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发表时间：
2015-01-01
影响因子：
2.6
通讯作者：
Naganawa, Shinji
中科院分区：
文献类型：
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作者：
Iwano, Shingo;Ito, Rintaro;Naganawa, Shinji
目的：探讨双能CT（DECT）碘浓度与手术切除原发性肺癌肺组织病理学的相关性。方法：回顾原发性肺癌肺切除患者的病历、术后病理记录和术前DECT图像。注射碘造影剂后，使用 140 kV 和 80 kV 管电压扫描动脉期和延迟期。使用肺结节应用软件计算原发肿瘤的三维碘浓度（碘体积）。结果：共分析了60例肺癌患者（男37例，女23例；年龄范围39-84岁；平均年龄69岁）62例肺癌。根据肿瘤分化程度（DTD），切除的肿瘤在组织病理学上分为高分化组（G1；n = 20）、中分化组（G2；n = 29）、低分化组（G3；n = 9）和未分化组（G4；n = 4）。延迟期碘量的平均+/-标准偏差在G1肿瘤中为59.6+/-18.6HU，在G2肿瘤中为46.5+/-11.3HU，在G3肿瘤中为34.3+/-15.0HU，在G4肿瘤中为28.8+/-6.4HU；组间观察到显着差异（p < 0.001）。单因素Logistic回归分析显示，早期和延迟期的碘量与DTD显着相关（分别为p = 0.006和p = 0.001），而性别、体重和肿瘤大小则不相关（分别为p = 0.084、p = 0.062和p = 0.391）。结论：肺癌的碘量与其DTD显着相关。高级别肿瘤的碘量往往低于低级别肿瘤。知识进步：DECT 测量的碘量可能是一种有价值的功能成像方法，可用于估计原发性肺癌的分化。
Objective: To investigate the correlation between iodine concentration of dual-energy CT (DECT) and histopathology of surgically resected primary lung cancers.Methods: We reviewed the medical records, postoperative pathological records and pre-operative DECT images of patients who underwent surgical lung resection for primary lung cancer. After injection of iodinated contrast media, arterial and delayed phases were scanned using 140- and 80-kV tube voltages. Three-dimensional iodine concentration (iodine volume) of primary tumours was calculated using lung nodule application software.Results: A total of 60 patients (37 males and 23 females; age range, 39-84 years; mean age, 69 years) with 62 lung cancers were analysed. The resected tumours were histopathologically classified into well-differentiated (G1; n = 20), moderately differentiated (G2; n = 29), poorly differentiated (G3; n = 9) and undifferentiated (G4; n = 4) groups by degree of tumour differentiation (DTD). The mean +/- standard deviation of iodine volume at the delayed phase was 59.6 +/- 18.6 HU in G1 tumours, 46.5 +/- 11.3 HU in G2 tumours, 34.3 +/- 15.0 HU in G3 tumours and 28.8 +/- 6.4 HU in G4 tumours; significant differences were observed between groups (p < 0.001). Univariate logistic regression analysis showed that iodine volumes both at the early and delayed phases were significantly correlated with DTD (p = 0.006 and p = 0.001, respectively), whereas gender, body weight and tumour size were not (p = 0.084, p = 0.062 and p = 0.391, respectively).Conclusion: The iodine volume of lung cancers was significantly associated with their DTD. High-grade tumours tended to have lower iodine volumes than low-grade tumours.Advances in knowledge: Iodine volume measured by DECT could be a valuable functional imaging method to estimate differentiation of primary lung cancer.