Initial evaluation of dual-energy computed tomography as an imaging biomarker for hepatic metastases from neuroendocrine tumor of the gastrointestinal tract.
Initial evaluation of dual-energy computed tomography as an imaging biomarker for hepatic metastases from neuroendocrine tumor of the gastrointestinal tract.
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DOI：
10.21037/qims-20-917
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发表时间：
2021-05
影响因子：
2.8
通讯作者：
Eddiel Cruz-Hernández;U. Mahmood;J. G. Golia Pernicka;V. Paroder;I. Petkovska;M. Gollub;J. Shia;K. Ganesh;D. Bates
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文献类型：
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作者：
Eddiel Cruz-Hernández;U. Mahmood;J. G. Golia Pernicka;V. Paroder;I. Petkovska;M. Gollub;J. Shia;K. Ganesh;D. Bates
背景：评价动脉相双能CT(DECT)扫描的定量碘参数作为胃肠道神经内分泌肿瘤(NETs)肝转移的肿瘤分级(TG)、有丝分裂指数(MI)和Ki-67增殖指数的成像生物标志物。成像生物标记物有可能提供有关病变形态以外的病理过程的相关临床信息。Net是世界卫生组织(WHO)TG根据MI和Ki-67增殖指数分类的一组罕见的异质性肿瘤。对这些病理特征和TG进行生物标志物成像可能是有用的。方法对2014年1月至2019年4月73例特殊的胃肠道网状肝转移瘤患者行腹部动脉相DECT扫描，排除后进行分析。使用GSIViewer软件(GE Healthcare，Madison，Wisconin)，椭圆形感兴趣区(ROI)由一位受过团契培训的腹部放射科医生放置在选定的肝转移瘤上。从病变ROI中提取定量碘浓度(IC)数据，计算各肝脏的归一化IC(病变IC/主动脉IC)和相对IC(病变IC/肝脏IC)。计算病变平均IC、归一化IC和相对IC与Ki-67增殖和有丝分裂指数的Spearman相关性。用学生t检验比较WHO TGS的病变平均IC、归一化IC和相对IC。结果Ki-67增殖指数和有丝分裂指数的归一化IC和相对IC之间的相关性都很弱。归一化IC与相对IC在区分G1、G2/3肿瘤转移方面无显著差异。结论我们的研究发现DECT定量参数在WHO TG中区分神经内分泌性肝转移的潜力有限，在这种情况下作为Ki-67增殖和有丝分裂指数的成像生物标志物的潜力也有限。我们发现Ki-67和定量碘参数之间缺乏相关性，这与现有文献报道的直肠和胃中这些参数正相关的情况相反。
Background To evaluate quantitative iodine parameters from the arterial phase dual-energy computed tomography (DECT) scans as an imaging biomarker for tumor grade (TG), mitotic index (MI), and Ki-67 proliferation index of hepatic metastases from neuroendocrine tumors (NETs) of the gastrointestinal (GI) tract. Imaging biomarkers have the potential to provide relevant clinical information about pathologic processes beyond lesion morphology. NETs are a group of rare, heterogeneous neoplasms classified by World Health Organization (WHO) TG, which is derived from MI and Ki-67 proliferation index. Imaging biomarkers for these pathologic features and TG may be useful. Methods Between January 2014 and April 2019, 73 unique patients with hepatic metastases from NET of the GI tract underwent DECT of the abdomen with an arterial phase were analyzed after exclusions. Using GSIViewer software (GE Healthcare, Madison, Wisconsin), elliptical regions of interest (ROIs) were placed over selected hepatic metastases by a fellowship trained abdominal radiologist. Quantitative iodine concentration (IC) data was extracted from the lesion ROIs, and the normalized IC (lesion IC/aorta IC) and relative IC (lesion IC/liver IC) for each liver were calculated. Spearman correlation was calculated for lesion mean IC, normalized IC, and relative IC to both Ki-67 proliferation and mitotic indices. Student's t-test was performed to compare lesion mean IC, normalized IC and relative IC between WHO TGs. Results There was very weak correlation between both normalized IC and relative IC for both Ki-67 proliferation and mitotic indices. A significant difference was not observed between normalized IC and relative IC to distinguish metastases from G1 and G2/3 tumors. Conclusions Our study finds limited potential for quantitative parameters from DECT to distinguish neuroendocrine hepatic metastases by WHO TG, as well as limited potential as an imaging biomarker for Ki-67 proliferation and mitotic indices in this setting. Our findings of a lack of correlation between Ki-67 and quantitative iodine parameters stands in contrast to existing literature that reports positive correlations for these parameters in the rectum and stomach.