Contrast-Enhanced Dual-Energy CT of Gastrointestinal Stromal Tumors Is Iodine-Related Attenuation a Potential Indicator of Tumor Response?
Contrast-Enhanced Dual-Energy CT of Gastrointestinal Stromal Tumors Is Iodine-Related Attenuation a Potential Indicator of Tumor Response?
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DOI：
10.1097/rli.0b013e31823003d2
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发表时间：
2012-01-01
影响因子：
6.7
通讯作者：
Fink, Christian
中科院分区：
文献类型：
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作者：
Apfaltrer, Paul;Meyer, Mathias;Fink, Christian
目的：评估转移性胃肠道间质瘤（GIST）患者腹部双能量CT（DECT）的真实非增强（TNE）和虚拟非增强（VNE）图像的相关性，并进一步研究DECT的碘相关衰减（伊拉）与Choi标准的相关性。材料与方法：24例连续转移性GIST患者（5例女性，年龄61 ± 10岁）使用第一代双源计算机断层扫描（CT）进行腹部DECT（80 kV，140 kV）。所有患者至少有一个或多个肝脏病变（中位数，4;最大值，9）。使用专用DECT软件算法处理图像数据，该算法设计用于评价软组织病变中的碘分布，并生成VNE CT图像。测定肿瘤密度（根据Choi标准）和病灶最大横径（根据实体瘤疗效评价标准[RECIST]）。结果：共观察到291个肝脏病灶，其中囊性220个，实性71个。平均病变尺寸为4.5 ± 3.2 cm（1.1-18.7 cm）。TNE图像中所有病变的平均衰减明显高于VNE图像（P = 0.0001）。Pearson统计显示，所有病变的伊拉和Choi标准之间具有良好的相关性，r = 0.843（P = 0.0001）。DECT显示进展性病变（23.3 +/- 9.5 HU）中的伊拉显著高于稳定或消退性病变（17.8 +/- 9.1 HU）（P = 0.0185）。同样，Choi标准在进行性（39.9 +/- 12.8 HU）和稳定/消退（31.1 +/- 10.3 HU）病变之间存在显著差异（P = 0.0003）。结论：DECT是一种有前途的成像方法，用于评估GIST的治疗反应，因为伊拉可能是比Choi标准更可靠的反应参数。从DECT计算的VNE CT数据可以消除对采集单独的未增强数据集的需要。
Objectives: To assess the correlation of true nonenhanced (TNE) and virtually nonenhanced (VNE) images of abdominal dual-energy computed tomography (DECT) in patients with metastatic gastrointestinal stromal tumors (GIST), and further to investigate the correlation of iodine-related attenuation (IRA) of DECT with the Choi criteria.Material and Methods: Twenty-four consecutive patients (5 women aged 61 +/- 10 years) with metastatic GIST underwent DECT of the abdomen (80 kV, 140 kV) using first-generation dual-source computed tomography (CT). All patients had at least one or more liver lesions (median, 4; maximum, 9). Image data were processed with a dedicated DECT software algorithm designed for evaluation of iodine distribution in soft tissue lesions, and VNE CT images were generated. The tumor density (according to Choi criteria) and the maximum transverse diameter of the lesions (according to Response Evaluation Criteria in Solid Tumors [RECIST]) were determined. TNE and VNE lesion attenuation and Choi criteria and IRA were correlated with each other.Results: A total of 291 liver lesions were evaluated, of which 220 were cystic and 71 were solid. The mean lesion size was 4.5 +/- 3.2 cm (1.1-18.7 cm). The mean attenuation of all lesions was significantly higher in the TNE images than in the VNE images (P = 0.0001). Pearson statistics revealed an excellent correlation of r = 0.843 (P = 0.0001) between IRA and Choi criteria for all lesions. DECT showed significantly higher IRA in progressive (23.3 +/- 9.5 HU) lesions compared with stable or regressive (17.8 +/- 9.1 HU) lesions (P = 0.0185). Similarly, the Choi criteria differed significantly between progressive (39.9 +/- 12.8 HU) and stable/regressive (31.1 +/- 10.3 HU) lesions (P = 0.0003).Conclusions: DECT is a promising imaging method for the assessment of treatment response in GIST, as IRA might be a more robust response parameter than the Choi criteria. VNE CT data calculated from DECT may eliminate the need for acquisition of a separate unenhanced data set.