光谱CT在原发性肝癌靶区勾画中应用价值的定量分析研究  

Quantitative Analysis of the Aplication Value of Spectral CT in Volume Delineation of Primary Hepatic Carcinoma

作　　者：朱一康 林俞锋 刘明[1] 刘胤良 翟福山[1] 刘兵[1] ZHU Yikang;LIN Yufeng;LIU Ming(Department of Oncology,Hebei Medical University Third Hospital,Shijiazhuang,Hebei Province 050051,P.R.China)

机构地区：[1]河北医科大学第三医院肿瘤科,石家庄050051

出　　处：《临床放射学杂志》2025年第4期657-663,共7页Journal of Clinical Radiology

基　　金：河北省医学科学研究课题计划项目(编号:20230683)。

摘　　要：目的 比较双能量CT(DECT)图像在原发性肝癌放疗靶区勾画中的应用价值。方法 搜集行上腹部增强DECT扫描的58例原发性肝癌患者的影像学资料,根据搜集图像扫描时期分为动脉期、静脉期和延迟期,测量不同序列图像大体肿瘤体积(GTV)的CT值。计算不同序列图像中GTV的对比度、噪声和对比噪声比(CNR),对所有序列图像获得的数据集进行统计分析,并对肿瘤与正常肝脏组织交界面辨析度主观评价进行分析。结果 相比常规增强CT图像,不同虚拟单能量40 keV、50 keV和60 keV图像上GTV的对比度分别增加了403%、179%和60%(P<0.05)。低能级虚拟单能量图像(VMI)中GTV的CNR均高于常规增强CT图像(P<0.05)。40 keV的VMI与常规增强CT图像中GTV的CNR增加了427%。低能级VMI图像的噪声之间无明显统计学差异(P>0.05)。在亚组分析中,40 keV的VMI中GTV对比度和CNR在动脉期、静脉期和延迟期中的中位数分别为68.60 HU、55.80 HU、25.20 HU(P<0.01)和6.03、5.14和2.02(P<0.01)。通过对图像进行主观评价分析提示40 keV图像更容易确定肝脏肿瘤与正常组织之间的边界。结论 与常规增强CT图像相比,双层探测器光谱CT增强扫描后40 keV的VMI中GTV的对比度和CNR明显增加,在原发性肝癌靶区勾画时增加了GTV的边界辨析度。Objective To compare the application value of dual-energy CT images in the delineation of target volume in radiotherapy for primary hepatocellular carcinoma.Methods The imaging data of 58 patients with primary liver cancer who underwent upper abdominal enhanced dual-energy CT scanning in our hospital were collected.According to the scanning phase of the collected images,they were divided into arterial phase,venous phase and delayed phase,and the CT values of Gross Tumor Volume(GTV) in different phases were measured.The contrast,noise and contrast to noise ratio of GTV in different sequence images were calculated,and the data sets obtained from all phase images were statistically analyzed,and the subjective evaluation of the delineation clarity of the interface between tumor and normal liver tissue was analyzed.Results Compared with conventional enhanced CT images,the contrast of GTV increased by 403%,179% and 60% on 40keV,50 keV and 60 keV images,respectively(P<0.05).The contrast noise ratio of GTV in low-level virtual monoenergetic images was higher than that in conventional enhanced CT images(P<0.05).The contrast noise ratio of GTV in 40keV virtual monoenergetic images was significantly different from that in conventional enhanced CT images,which increased by 427%.There was no significant difference in image noise between low level VMI images(P>0.05).In subgroup analysis,the median contrast and CNR of GTV in arterial,venous and delayed phases at 40 keV were 68.60 HU,55.80 HU,25.20 HU(P<0.01) and 6.03,5.14,2.02(P<0.01),respectively.The subjective evaluation and analysis of the images suggested that 40 keV images were easier to determine the boundary between liver tumor and normal tissue.Conclusion Compared with conventional enhanced CT images,the contrast and noise ratio of GTV in the virtual monochromatic images at 40 keV after enhanced scanning of dual-layer spectral detector CT are significantly increased,which increases the boundary delineation of GTV in the delineation of primary liver cancer.

关 键 词：原发性肝癌 双层探测器光谱CT 靶区勾画 对比度 

分 类 号：R73[医药卫生—肿瘤]