-
2013年我国因支气管肺癌病死的患者共546 259例,占全球该类癌症病死例数(1 639 646)的1/3[1]。2018年国际癌症研究机构指出,我国的男性及女性肺部恶性肿瘤的病死率均居恶性肿瘤的第一位[2]。因此,肺部肿瘤良恶性鉴别、肺癌分期及治疗后的疗效评估对患者的生存率和生活质量至关重要。双能量CT(dual energy computed tomography,DECT)可用于区别不同组织的特征,例如由骨创伤引起的骨髓病变研究,肾囊肿的体内外研究,尿酸的沉积研究等[3-5]。DECT可用于区分乏血供小病变的良、恶性,显示肿瘤组织中的坏死组织区域,鉴别肿瘤患者正常淋巴结、炎性淋巴结和转移性淋巴结等[6-7]。因此,研究DECT在肺部肿瘤中的应用是非常有价值的。
双能量CT在肺部肿瘤中的应用和现状
Application and current status of dual energy CT in lung tumors
-
摘要: 肺部肿瘤良恶性鉴别、肺癌分期及治疗后疗效评估对患者生存率和生活质量至关重要。近年来,双能量CT(DECT)技术的出现,使DECT在肺部肿瘤领域的研究成为一大热点。笔者概述了DECT技术以及如何使用该技术鉴别肺部良性和恶性结节肿块、DECT在肺部肿瘤分期和治疗反应中的应用等。
-
关键词:
- 体层摄影术, X线计算机 /
- 肺肿瘤 /
- 应用
Abstract: The identification of benign and malignant lung tumors, the staging of malignant lung tumors, and the assessment of post-treatment efficacy are critical for patient survival and quality of life. Dual-energy CT(DECT) has become a hot topic in the field of lung tumor research with the emergence of DECT technology in recent years. The authors outline DECT technology and its use in identifying benign and malignant nodules in the lungs, staging lung tumors, and evaluating therapeutic response.-
Key words:
- Tomography, X-ray computed /
- Lung neoplasms /
- Application
-
[1] Fitzmaurice C, Dicker D, Pain A, et al. The global burden of cancer 2013[J]. JAMA Oncol, 2015, 1(4): 505−527. DOI: 10.1001/jamaoncol.2015.0735. [2] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394−424. DOI: 10.3322/caac.21492. [3] Cao JX, Wang YM, Kong XQ, et al. Good interrater reliability of a new grading system in detecting traumatic bone marrow lesions in the knee by dual energy CT virtual non-calcium images[J]. Eur J Radiol, 2015, 84(6): 1109−1115. DOI: 10.1016/j.ejrad.2015.03.003. [4] Mileto A, Nelson RC, Samei E, et al. Impact of dual-energy multi-detector row CT with virtual monochromatic imaging on renal cyst pseudoenhancement: in vitro and in vivo study[J]. Radiology, 2014, 272(3): 767−776. DOI: 10.1148/radiol.14132856. [5] Dalbeth N, House ME, Aati O, et al. Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout: a dual energy CT study[J]. Ann Rheum Dis, 2015, 74(5): 908−911. DOI: 10.1136/annrheumdis−2014−206397. [6] Shi JW, Dai HZ, Shen L, et al. Dual-energy CT: clinical application in differentiating an adrenal adenoma from a metastasis[J]. Acta Radiol, 2014, 55(4): 505−512. DOI: 10.1177/0284185113501660. [7] Sun X, Shao XD, Chen HS. The value of energy spectral CT in the differential diagnosis between benign and malignant soft tissue masses of the musculoskeletal system[J]. Eur J Radiol, 2015, 84(6): 1105−1108. DOI: 10.1016/j.ejrad.2015.02.028. [8] Johnson TRC. Dual-energy CT: general principles[J]. AJR Am J Roentgenol, 2012, 199(5S): S3−8. DOI: 10.2214/AJR.12.9116. [9] Thaiss WM, Sauter AW, Bongers M, et al. Clinical applications for dual energy CT versus dynamic contrast enhanced CT in oncology[J]. Eur J Radiol, 2015, 84(12): 2368−2379. DOI: 10.1016/j.ejrad.2015.06.001. [10] Goo HW, Goo JM. Dual-energy CT: new horizon in medical imaging[J]. Korean J Radiol, 2017, 18(4): 555−569. DOI: 10.3348/kjr.2017.18.4.555. [11] Faby S, Kuchenbecker S, Sawall S, et al. Performance of today's dual energy CT and future multi energy CT in virtual non-contrast imaging and in iodine quantification: a simulation study[J]. Med Phys, 2015, 42(7): 4349−4366. DOI: 10.1118/1.4922654. [12] Knöß N, Hoffmann B, Krauss B, et al. Dual energy computed tomography of lung nodules: differentiation of iodine and calcium in artificial pulmonary nodules in vitro[J]. Eur J Radiol, 2011, 80(3): e516−e519. DOI: 10.1016/j.ejrad.2010.11.001. [13] Hou WS, Wu HW, Yin Y, et al. Differentiation of lung cancers from inflammatory masses with dual-energy spectral CT imaging[J]. Acad Radiol, 2015, 22(3): 337−344. DOI: 10.1016/j.acra.2014.10.004. [14] Li M, Zheng XP, Li JY, et al. Dual-energy computed tomography imaging of thyroid nodule specimens: comparison with pathologic findings[J]. Invest Radiol, 2012, 47(1): 58−64. DOI: 10.1097/RLI.0b013e318229fef3. [15] Chae EJ, Song JW, Seo JB, et al. Clinical utility of dual-energy CT in the evaluation of solitary pulmonary nodules: initial experience[J]. Radiology, 2008, 249(2): 671−681. DOI: 10.1148/radiol.2492071956. [16] Winer-Muram HT. The solitary pulmonary nodule[J]. Radiology, 2006, 239(1): 34−49. DOI: 10.1148/radiol.2391050343. [17] Chae EJ, Song JW, Krauss B, et al. Dual-energy computed tomography characterization of solitary pulmonary nodules[J]. J Thorac Imaging, 2010, 25(4): 301−310. DOI: 10.1097/RTI.0b013e3181e16232. [18] Kawai T, Shibamoto Y, Hara M, et al. Can dual-energy CT evaluate contrast enhancement of ground-glass attenuation? phantom and preliminary clinical studies[J]. Acad Radiol, 2011, 18(6): 682−689. DOI: 10.1016/j.acra.2010.12.014. [19] Zhang Y, Tang J, Xu JR, et al. Analysis of pulmonary pure ground-glass nodule in enhanced dual energy CT imaging for predicting invasive adenocarcinoma: comparing with conventional thin-section CT imaging[J]. J Thorac Dis, 2017, 9(12): 4967−4978. DOI: 10.21037/jtd.2017.11.04. [20] Jepperson MA, Cernigliaro JG, Ibrahim ESH, et al. In vivo comparison of radiation exposure of dual-energy CT versus low-dose CT versus standard CT for imaging urinary calculi[J]. J Endourol, 2015, 29(2): 141−146. DOI: 10.1089/end.2014.0026. [21] Ogawa M, Hara M, Imafuji A, et al. Dual-energy CT can evaluate both hilar and mediastinal lymph nodes and lesion vascularity with a single scan at 60 seconds after contrast medium injection[J]. Acad Radiol, 2012, 19(8): 1003−1010. DOI: 10.1016/j.acra.2012.03.024. [22] Liu XW, Ouyang D, Li H, et al. Papillary thyroid cancer: dual-energy spectral CT quantitative parameters for preoperative diagnosis of metastasis to the cervical lymph nodes[J]. Radiology, 2014, 275(1): 167−176. DOI: 10.1148/radiol.14140481. [23] Liu HH, Yan FH, Pan ZL, et al. Evaluation of dual energy spectral CT in differentiating metastatic from non-metastatic lymph nodes in rectal cancer: initial experience[J]. Eur J Radiol, 2015, 84(2): 228−234. DOI: 10.1016/j.ejrad.2014.11.016. [24] Tawfik AM, Razek AA, Kerl JM, et al. Comparison of dual-energy CT-derived iodine content and iodine overlay of normal, inflammatory and metastatic squamous cell carcinoma cervical lymph nodes[J]. Eur Radiol, 2014, 24(3): 574−580. DOI: 10.1007/s00330−013−3035−3. [25] Li XB, Meng XY, Ye ZX. Iodine quantification to characterize primary lesions, metastatic and non-metastatic lymph nodes in lung cancers by dual energy computed tomography: an initial experience[J]. Eur J Radiol, 2016, 85(6): 1219−1223. DOI: 10.1016/j.ejrad.2016.03.030. [26] Choi H, Charnsangavej C, Faria SC, et al. Correlation of computed tomography and positron emission tomography in patients with metastatic gastrointestinal stromal tumor treated at a single institution with imatinib mesylate: proposal of new computed tomography response criteria[J]. J Clin Oncol, 2007, 25(13): 1753−1759. DOI: 10.1200/JCO.2006.07.3049. [27] Kim YN, Lee HY, Lee KS, et al. Dual-energy CT in patients treated with anti-angiogenic agents for non-small cell lung cancer: new method of monitoring tumor response?[J]. Korean J Radiol, 2012, 13(6): 702−710. DOI: 10.3348/kjr.2012.13.6.702. [28] 顾圣佳. 双能量CT成像在非小细胞肺癌非手术治疗疗效评估中的应用研究[D]. 上海: 上海交通大学, 2015.
Gu SJ. The study of quantitative therapy response assessment of non-small cell lung cancer with dual-energy computed tomography[D]. Shanghai: Shanghai Jiao Tong University, 2015.[29] Sun YS, Zhang XY, Cui Y, et al. Spectral CT imaging as a new quantitative tool? Assessment of perfusion defects of pulmonary parenchyma in patients with lung cancer[J]. Chin J Cancer Res, 2013, 25(6): 722−728. DOI: 10.3978/j.issn.1000−9604.2013.12.01. [30] Chae EJ, Kim N, Seo JB, et al. Prediction of postoperative lung function in patients undergoing lung resection: dual-energy perfusion computed tomography versus perfusion scintigraphy[J]. Invest Radiol, 2013, 48(8): 622−627. DOI: 10.1097/RLI.0b013e318289fa55. [31] Bahig H, Campeau MP, Lapointe A, et al. Phase 1-2 study of dual-energy computed tomography for assessment of pulmonary function in radiation therapy planning[J]. Int J Radiat Oncol Biol Phys, 2017, 99(2): 334−343. DOI: 10.1016/j.ijrobp.2017.05.051.
计量
- 文章访问数: 15383
- HTML全文浏览量: 13753
- PDF下载量: 32