能谱CT辅助肺癌诊疗应用的研究进展  

Research progress on the application of spectral CT in the diagnosis and treatment of lung cancer

作　　者：钟慧 杨厚义 徐菁 尹勇 ZHONG Hui;YANG Houyi;XU Jing;YIN Yong(Department of Radiation Physics Technology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Jinan 250117,China)

机构地区：[1]山东省肿瘤防治研究院(山东省肿瘤医院)放射物理技术科,山东第一医科大学(山东省医学科学院),山东济南250117

出　　处：《社区医学杂志》2023年第11期594-598,共5页Journal Of Community Medicine

基　　金：国家自然科学基金(12275162,82072094)。

摘　　要：在我国肺癌的发病率和死亡率均较高,肺癌的诊断主要依靠CT成像。近年来,CT设备更新迅速,双能CT(DECT)通过单次采集可以生成多个后处理数据集,拓宽了胸部肿瘤成像的潜力。本综述对能谱CT的基本原理及其在肺癌诊疗中的应用进行总结。以“DECT”“肺癌”“诊疗”为关键词,检索2012-01-01-2022-12-31中国知网及PubMed相关文献。最终纳入分析文献46篇。结果显示,DECT主要分为双源双能CT、双层探测器CT以及单源双能CT,胸部成像中常用的后处理技术包括虚拟非增强(VNC)图像、碘增强图像(碘图)、虚拟单能量图像(VMI)、有效原子序数(Zeff)图像等。DECT对于肺部肿块良恶性的评估、组织学起源、肺癌的组织学分类及分化程度方面均有重要的诊断价值。DECT相关参数对于淋巴结转移、骨转移的诊断也具有重要价值。在靶区勾画、计划设计方面,DECT可以获得电子密度图像,可以改进剂量计算及肿瘤勾画。DECT碘相关参数在预测肺癌患者的放化疗效果、预后方面也具有独特优势。提示,能谱CT可以无创性地对肺癌定性、定量诊断,在肺癌的分期诊断、治疗疗效评估及预后方面发挥了重要作用,在放疗的靶区勾画、计划设计方面也展现了初步的优势。Lung cancer is the disease with the highest morbidity and mortality in China.The diagnosis of lung cancer mainly depends on CT imaging.In recent years, CT equipment has been updated rapidly.Dual-energy CT(DECT) can generate multiple post-processing data sets through a single acquisition, which broadens the potential of lung tumor imaging.This article reviews the basic principle of spectral CT and its application in the diagnosis and treatment of lung cancer.The related literature from January 1,2012 to December 31,2022 was searched in PubMed and China National Knowledge Infrastructure with "DECT", "lung cancer" and "diagnosis and treatment" as keywords.Finally, 46 articles were included in the analysis.The results showed that DECT was mainly divided into dual-source DECT,dual-layer detector DECT and single-source DECT.The commonly used post-processing techniques in chest imaging include virtual non-contrast(VNC) image, iodine-enhanced image(iodine map),virtual monoenergetic imaging(VMI),effective atomic number Z(Zeff) image.DECT has important diagnostic value in the evaluation of benign and malignant pulmonary masses, histological origin, histological classification and differentiation of lung cancer.DECT-related parameters also play an important role in the diagnosis of lymph node metastasis and bone metastasis.In terms of target delineation and planning design, DECT can obtain electron density images, which can improve dose calculation and tumor delineation.DECT iodine-related parameters also have strong advantages in predicting the effect of radiotherapy and chemotherapy and predicting the prognosis of patients with lung cancer.Spectral CT can make a non-invasive qualitative and quantitative diagnosis of lung cancer.It plays an important role in staging diagnosis, therapeutic effect evaluation and prognosis of lung cancer.It also shows preliminary advantages in the target area delineation and planning design of radiotherapy.

关 键 词：能谱CT 双能量CT 肺肿瘤 综述文献 

分 类 号：R734.2[医药卫生—肿瘤]