摘要
目的 探讨双层探测器光谱CT获得的各光谱参数在进展期胃癌术前化疗前后的数据变化,并评估各参数在进展期胃癌化疗疗效中临床价值.方法 回顾性分析2021年3月至2024年2月我院经病理证实的28例经短期(4周期)化疗好转[包括实体瘤疗效评价标准(RECIST 1.1标准)完全缓解(CR)、部分缓解(PR)]的进展期胃癌患者术前及短期化疗后光谱CT图像,测量及计算动脉期、静脉期所有光谱参数,包括标准化碘密度值(NIC)、光谱曲线斜率[K(40～100keV)]值及有效原子系数(Zeff),比较2组间各光谱参数的差异,并使用受试者工作特征曲线(ROC)分析灵敏度、特异度以衡量每个参数的诊断效能,比较各AUC(曲线下面积)的差异.结果 ①动脉期及静脉期NIC、K(40～100 keV)、Zeff值在治疗前均高于治疗后,且各参数治疗前后数值差异均有统计学意义(P＜0.05).②ROC曲线进一步分析NIC、K(40～100 keV)、Zeff联合应用诊断进展期胃癌治疗疗效效能.动脉期NIC、K(40～100 keV)、Zeff曲线下面积(AUC)分别为:0.772、0.759、0.804;NIC、K(40～100 keV)、Zeff 灵敏度和特异度分别为:71％和 78％,61％和 86％,75％和 75％;静脉期 NIC、K(40～100 keV)、Zeff曲线下面积(AUC)分别为:0.810、0.779、0.895;NIC、K(40～100 keV)、Zeff灵敏度和特异度分别为:96％和54％,79％和71％,75％和89％.结论 光谱CT NIC、K(40～100 keV)、Zeff参数可作为评估进展期胃癌术前化疗疗效的可靠标记物,联合应用更能提高诊断的准确率.
Abstract
Objective To investigate the data changes of each spectral parameter obtained by double-layer de-tector spectral CT before and after preoperative chemotherapy for progressive gastric cancer,and to assess the clinical value of each parameter in the efficacy of chemotherapy for progressive gastric cancer.Methods The preoperative and short-term post-chemotherapy spectral CT images of 28 pathologically confirmed patients with progressive gastric cancer who had improved with short-term(4 cycles)chemotherapy including Response Evaluction Crileria In Solid Tumours(RECIST 1.1)standard Complete Response(CR)and Partral Response(PR)in our hospital from March 2021 to February 2024 were retrospectively analyzed,and measured and calculated all the spectral parameters of the arterial and venous phases,including the standardized iodine density value(NIC),spectral curve.We measured and calculated all the spectral parameters in arterial and venous phases,including standardized iodine density value(NIC),spectral curve slope[K(40～100 keV)]and effective atomic coefficient(Zeff),compared the differences of each spectral param-eter between the two groups,and analyzed the sensitivity and specificity to measure the diagnostic efficacy of each pa-rameter by using the working characteristic curve(ROC)of the subjects to compare the differences of the AUC(area under the curve).Results ① The values of NIC,K(40～100 keV),and Zeff in arterial and venous phases were higher before than after treatment,and the differences in the values of each parameter before and after treatment were statisti-cally significant(P＜0.05).② The ROC curves were further analyzed for the combined application of NIC,K(40～100 keV),Zeff diagnosis of progressive gastric cancer treatment efficacy.The area under the curve(AUC)of NIC,K(40～100 keV)and Zeff in arterial phase were 0.772,0.759 and 0.804,respectively,the sensitivity and specificity of NIC,K(40～100 keV)and Zeff were 71％and 78％,61％and 86％,75％and 75％respectively,area under the curve(AUC)for NIC,K(40～100 keV),and Zeff in the venous phase were:0.810,0.779,and 0.895,respectively,and the sensitivity and specificity for NIC,K(40～100 keV),and Zeff were 96％and 54％,79％and 71％,and 75％and 89％,respective-ly.Conclusion Spectral CT NIC,K(40～100 keV),and Zeff parameters can be used as reliable markers to assess the efficacy of preoperative chemotherapy in progressive gastric cancer,and the combined application can better im-prove the diagnostic accuracy.
基金项目
福建省龙岩市科技计划项目(2022LYF17030)
维普
万方数据