能谱CT评估非小细胞肺癌经皮氩氦刀冷冻消融术疗效  

Spectral CT evaluation on the treatment effect of percutaneous cryoablation for non-small cell lung cancer

作　　者：庞冉[1] 姜敏[2] 刘明[1] 王玲璞[1] 刘冰[1] 赵晶[1] 

机构地区：[1]北京中医药大学东方医院放射科,北京100078 [2]北京中医药大学东方医院肿瘤科,北京100078

出　　处：《中国医学影像技术》2015年第8期1221-1225,共5页Chinese Journal of Medical Imaging Technology

基　　金：北京市丰台区卫生系统研究项目

摘　　要：目的探索能谱CT成像对非小细胞肺癌氩氦刀冷冻消融术疗效评估的应用价值。方法收集接受CT引导下氩氦刀冷冻消融术的非小细胞肺癌患者23例（30次）,于术前及术后（1~3个月）行GSI模式增强CT扫描,测量/计算手术前后病灶最大面积（S）、最大径（L）、强化区最大径（LE）、中心区和边缘区CT均值及碘含量均值变化率;分析WHO、RECIST、mRECIST标准及CTm-rec、Im-rec标准下,完全缓解（CR）、部分缓解（PR）、情况稳定（SD）、病情进展（PD）,有效（CR＋PR）、无效（SD＋PD）患者的1年期生存率及整体生存期（OS）差异。结果 WHO、RECIST、mRECIST及CTm-rec标准下,1年期生存率随疗效变差而下降。RECIST标准下PR、SD、PD患者的OS差异有统计学意义（P=0.02）;RECIST、mRECIST标准下SD与PD患者、CTm-rec标准下PR与PD患者、Im-rec标准下PR与SD患者的OS差异均有统计学意义（P=0.01、0.04、0.03、0.03）。CTm-rec及Im-rec标准下有效与无效患者的OS差异有统计学意义（P=0.04、0.03）。结论 Im-rec标准更敏感,CTm-rec标准可对术后病灶复发进行预测。能谱CT多参数联合应用有助于对非小细胞肺癌氩氦刀冷冻消融术后疗效的早期、全面评估。Objective To explore the value of spectral CT imaging on evaluation of the treatment effect of percutaneous cryoablation for non-small cell lung cancer. Methods Totally 23 patients （30 times） with non-small cell lung cancer under- went percutaneous cryoablation. All the patients underwent contrast enhanced CT scan with spectral CT imaging mode both before and 3 months after the surgery. The maximum area （S）, maximum diameter （L）, maximum enhancing diameter （LE）, the mean values of CT numbers and iodine content in the central and peripheral region for each lesion were meas- ured, and their corresponding change rates after surgery were calculated. According to WHO, RECIST, mRECIST re- sponse criteria and CTm-rec, the differences of 1-year survival and overall survival （OS） were analysed between complete response （CR）, partial response （PR）, stable disease （SD） and progressive disease （PD） groups, and between effective and noneffective patients. Results According to WHO, RECIST, mRECIST and CTm-rec criteria, 1-year survival decreased as the assessment got worsing. According to RECIST criteria, the difference of OS were statistically significant among PR, SD, PD groups （P= 0. 02）. According to RECIST and mRECIST criteria, the difference of OS were statistically significant between SD and PD groups （P=0.01, 0.04）. According to CTm-rec criteria, the difference of OS were statistically signif- icant between PR and PD groups （P=0.03）, According to Im-rec criteria, the difference of OS were statistically significant between SD and PR groups （P=0.03）. According to CTm-rec and Im-rec criteria, the difference of OS were statistically significant between effective and noneffective patients （P=0.04, 0.03）. Conclusion The iodine content is the most sensi- tive. The CTm-ree criteria is helpful for predicting lesions recurrence after the surgery. Spectral CT multi-parameter meas- urements can be used to evaluate the treatment effect of percutaneous eryoablation early and com

关 键 词：体层摄影术 X线计算机 能谱成像 癌 非小细胞肺 氩氦刀 治疗结果 

分 类 号：R734.2[医药卫生—肿瘤] R814.42[医药卫生—临床医学]