Objective:To explore the feasibility of dual-energy CT iodine quantitative parameters in the evaluation of oc-cult peritoneal metastasis (OPM) of ovarian cancer. Materials and Methods:The data of 92 patients with ovarian cancer(19 cases of OPM and 73 cases of negative peritoneal metastasis) who underwent dual energy CT scanning before operation were analyzed retrospectively,and CA125 and HE4 were collected. Two observers independently measured iodine concentration in the enhanced arterial phase,venous phase and delayed phase(AP-IC,VP-IC,DP-IC) of the maximum solid components of the primary tumor,and calculated the normalized iodine concentrations (AP-NIC,VP-NIC,DP-NIC). Intra-class correlation coeffi-cient (ICC) was used to compare the consistency of all measurements obtained by the two observers. Rank sum test was used to compare the differences of clinical and imaging parameters between the two groups. Logistic regression analysis was used to screen for independent risk factors and establish a joint model. The area under the curve (AUC),sensitivity and specificity were used to evaluate the effectiveness of univariate and joint model,and the DeLong test was used to compare the AUC differences. Results:There was no statistically significant difference in age,menstrual status,and CA19-9 levels between the two groups of patients(P>0.05). However,there was a significant difference in pathological classification,CA125 and HE4 lev-els between the two groups of patients (P<0.05),the CA125 level in OPM patients was significantly higher than that in NPM patients (186.90 U/mL vs. 67.09 U/mL,P=0.005),the HE4 of OPM patients was significantly higher than that of NPM patients (291.00 pmol/L vs. 103.60 pmol/L,P=0.001). The consistency of all imaging parameter values was good(ICC>0.75). The enhanced IC and NIC of OPM ovarian cancer were significantly higher than those of NPM ovarian cancer (9.96 mg/mL vs. 4.91 mg/mL,13.36 mg/mL vs. 6.10 mg/mL,13.82 mg/mL vs. 5.37 mg/mL,0.12 vs. 0.06,0.46 vs. 0.20,0.56 vs. 0.30,all P<0.05). HE4 and VP-NIC were independent risk factors for predicting OPM. The AUC of the joint model composed of HE4 and VP-NIC was 0.812,which was not significantly different from that of VP-NIC and HE4 (P>0.05),but the specificity of the joint model was significantly higher than that of HE4 (P<0.001). Conclusion:Dual energy CT iodine quantitative parameters provide a new choice for predicting OPM before treatment in ovarian cancer patients,and combination with HE4 has potential value in pre-dicting OPM.
万方数据
维普
