The Value of Dual-energy Low-dose CT Mono Technique in Evaluation of Neoadjuvant Chemotherapy for Breast Cancer
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摘要: 目的：探讨双能量CT Mono技术评估乳腺癌新辅助化疗（NAC）疗效的价值。方法：收集30例原发性乳腺癌患者的新辅助化疗前后的双能量能谱CT图像，根据RECIST标准进行临床疗效分组，分为：①NAC有效组：包括完全缓解（CR）、部分缓解（PR）病例；②NAC无效组：包括疾病稳定（SD）、疾病进展（PD）病例。术后根据（MP）病理分级系统，分为：①有效组：包括MP分级4～5级病例；②无效组，包括MP分级1～3级病例。将有效组与无效组间标准化碘浓度（NIC）、有效组与无效组间NIC变化率进行统计学分析及比较。结果：于上述分组中，NAC前有效组与无效组间NIC值差异无统计学意义，NAC后各分组中NIC值均不同程度降低，下降的差异具有统计学意义。结论：NIC值的下降率与化疗疗效呈正相关，NIC值可作为乳腺癌NAC疗效的评价指标。Abstract: Objective: To discuss the evaluation effectiveness of dual-energy CT Mono technology in neoadjuvant chemotherapy (NAC) of breast cancer. Methods: Dual-energy spectrum CT images of 30 patients with primary breast cancer before and after neoadjuvant chemotherapy were collected, and the clinical efficacy was divided into two groups according to RECIST 1.1 standard, (1) NAC effective group, including complete response (CR) and partial response (PR). (2) NAC invalid group: included stable disease (SD), progressive disease (PD) cases. After operation, according to Miller and Payne (MP) pathological grading system, the patients were divided into (1) effective group, including the cases of MP grade 4 and 5, (2) ineffective group, including the cases of MP grade 1-3. Statistical analysis and comparison of NIC and rate of NIC change between effective and ineffective groups. Results: In the above groups, there was no statistically significant difference in NIC value between the groups before NAC, and the NIC value in the above groups after NAC had different degrees of decline, the difference among the groups was statistically significant. The NIC value difference between the groups at venous stage was more significant than that at arterial stage. Tumor volume change rate and ΔNIC were positively correlated. Conclusion: The decrease rate of NIC value is positively correlated with the efficacy of chemotherapy, and NIC value can be used as the evaluation index of NAC efficacy of breast cancer.
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