The Value of Dual-energy Low-dose CT Mono Technique in Evaluation of Neoadjuvant Chemotherapy for Breast Cancer
-
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.
-
-
[1] ELERI L D. Breast cancer[J]. Medicine, 2012, 40(1):5-9.
[2] ALVES W, BONATELLI M, DUFLOTH R, et al. CAIX is a predictor of pathological complete response and is associated with higher survival in locally advanced breast cancer submitted to neoadjuvant chemotherapy[J]. BMC Cancer, 2019, 19(1):1173. DOI: 10.21203/rs.2.13679/v2.
[3] 周立艳, 史业辉, 贾勇圣, 等. 75例老年乳腺癌患者新辅助化疗疗效及预后分析[J]. 中华乳腺病杂志(电子版), 2014, 8(3 ):20-26. DOI:10.3877/cma.j.issn.1674-0807.2014.03.005. ZHOU L Y, SHI Y H, JIA Y S, et al. Efficacy and prognosis of neoadjuvant chemotherapy in 75 elderly patients with breast cancer[J]. The Mammary Gland Disease (electronic), 2014, 8(3):20-26. DOI:10.3877/j.1674-0807.2014.03.005. (in Chinese).
[4] EL-ADALANY M A, HAMED E D. Role of dynamic contrast enhanced MRI in evaluation of post-operative breast lesions[J]. The Egyptian Journal of Radiology and Nuclear Medicine, 2016, 47(2):631-640.
[5] YANG L, LI Y, SHI G F, et al. The concentration of iodine in perigastric adipose tissue:A novel index for the assessment of serosal invasion in patients with gastric cancer after neoadjuvant chemotherapy[J]. Digestion, 2018, 98(2):87-94. DOI: 10.1159/000487709.
[6] MOROHASHI H, SAKAMOTO Y, ICHINOHE D, et al. Evaluation of the therapeutic effect of using dual-energy CT for rectal cancer after neoadjuvant chemotherapy[J]. Gan to Kagaku Ryoho. Cancer & Chemotherapy, 2016, 43(12):1482-1484.
[7] SARGENT D, RUBINSTEIN L, LACOMBE D, et al. New response evaluation criteria in solid tumours:Revised RECIST guideline (version 1.1)[J]. European Journal of Cancer, 2009, 45(2):228-247.
[8] 王碧芸, 龚成成, 胡夕春. 2015版《中国抗癌协会乳腺癌诊治指南与规范》:药物治疗策略的解读[J]. 中华乳腺病杂志(电子版), 2016, 10(2 ):65-70. WANG B Y, GONG C C, HU X C. 2015 version of the Chinese anti-cancer association guidelines and norms for diagnosis and treatment of breast cancer:Interpretation of drug therapy strategy[J]. The Mammary Gland Disease (electronic), 2016, 10(2):65-70.
[9] ERALP Y. Preoperative therapy for operable breast cancer[J]. Breast Disease,2019, 2(2):223-238.
[10] CHO H, KIM C, OH M, et al. Clinical outcome after breast conserving surgery and radiation therapy for early breast cancer[J]. Journal of the Korean Society for Therapeutic Radiology & Oncology, 2008, 26(4):204-212.
[11] 郭轩, 唐甜甜, 王新乐, 等. 超声光散射成像技术对乳腺癌新辅助化疗疗效早期评价的研究[J]. 中华超声影像学杂志, 2018, 27(2):160-163. DOI:10.3760/cma.j.issn.1004-4477.2018.02.014. GUO X, TANG T T, WANG X L, et al. Ultrasonic light scattering imaging for the early evaluation of the efficacy of neoadjuvant chemotherapy for breast cancer[J]. The Ultrasonic Imaging Journal, 2018, 27(2):160-163. DOI:10.3760/j.1004-4477.2018.02.014. (in Chinese).
[12] 林小慧, 许梅, 马捷. 采用MRI评估不同分子分型乳腺癌新辅助化疗的疗效[J]. 中华放射学杂志, 2019, 53(11):1020-1024. DOI:10.3760/cma.j.issn.1005.1201.2019.11.018. LIN X H, XU M, MA J. Using MRI to evaluate different molecular classification the curative effect of neoadjuvant chemotherapy of breast cancer[J]. Chinese Journal of Radiology, 201953(11):1020-1024. DOI:10.3760/j.1005.1201.2019.11.018. (in Chinese).
[13] SUGAWARA H, TAKAYANAGI T, ISHIKAWA T, et al. New fast kVp switching dual-energy CT:Reduced severity of beam hardening artifacts and improved image quality in reduced-iodine virtual monochromatic imaging[J]. Academic Radiology, 2019, 27(11):1586-1593. DOI:10.1016/j.acra. 2019.11.015.
[14] 王贵生, 高建华, 赵帅, 等. 肝脏增强扫描门静脉期能谱CT与传统多层螺旋CT辐射剂量和图像质量的比较[J]. 中华放射学杂志, 2013, 47(4):340-343. DOI:10.3760/cma.j.issn.1005-1201.2013.04.011. WANG G H, GAO J H, ZHAO S, et al. Comparison of radiation dose and image quality between portal vein phase energy spectrum CT and traditional MSCT[J]. The Chinese Journal of Radiology, 2013, 47(4):340-343. DOI:10.3760/j.1005-1201.2013.04.011. (in Chinese).
[15] 徐秋贞, 邵海磊, 吕燕, 等. 胸部能谱成像模式与常规CT扫描的辐射剂量及图像质量的仿真体模研究[J]. 中华放射医学与防护杂志, 2017, 37(12):957-961. DOI:10.3760/cma.j.issn.0254-5098. 2017.12.015. XU Q Z, SHAO H L, LV Y, et al. Study on radiation dose and image quality of chest energy spectrum imaging model and conventional CT scan simulation volume model[J]. The Chinese Journal of Radiological Medicine and Protection, 2017, 5(12):957-961. DOI:10.3760/j.0254-5098.2017.12.015. (in Chinese).
[16] HERIN E, GARDAVAUD F, CHIARADIA M, et a1. Use of model-based iterative reconstruction (MBIR) in reduced-dose CT for routine follow-up of patients with malignant lymphoma:Dose savings, image quality and phantom study[J]. European Radiology, 2015, 25(8):2362-2370.
[17] 傅耀斌. 能谱CT成像在诊断胃癌及新辅助化疗疗效评估中的价值[J]. 医疗装备, 2018, 31(14):46-47. FU Y B. The value of ENERGY spectrum CT imaging in the diagnosis of gastric cancer and the efficacy evaluation of neoadjuvant chemotherapy[J]. Medical Equipment, 2018, 31(14):46-47. (in Chinese).
[18] 赵致楷. 宝石能谱CT在直肠癌新辅助治疗疗效评估中的价值[D]. 太原:山西医科大学, 2015. DOI: 10.7666/d.D649855. [19] ANDRÉ EULER, SOLOMON J, MAZUROWSKI M A, et al. How accurate and precise are CT based measurements of iodine concentration? A comparison of the minimum detectable concentration difference among single source and dual source dual energy CT in a phantom study[J]. European Radiology, 2019, 29(4):2069-2078.
[20] 石磊, 张欢, 潘自来, 等. 双源双能量CT在晚期胃癌患者化疗疗效评价中的应用价值研究[J]. 中国医学计算机成像杂志, 2013, 19(1):28-32. DOI:10.3969/j.issn.1006-5741.2013.01.008. SHI L, ZHANG H, PAN Z L, et al. The application value of dual-source dual-energy CT in the evaluation of chemotherapy efficacy in patients with advanced gastric cancer[J]. Journal of Medical Computer Imaging, 2013, 19(1):28-32. DOI:10.3969/j.1006-5741.2013.01.008. (in Chinese).
-
期刊类型引用(5)
1. 刘佳萍，张卫国. 胸部定量CT对COPD患者治疗反应预测因素分析. 河北医药. 2024(03): 376-379 . 
百度学术
2. 曹亚娟，王警建，金晨望. 各期COPD支气管管壁和DLco的相关性分析. 贵州医药. 2024(06): 862-864 . 百度学术
3. 马俊丽，舒建军，何平，苏海龙. Revolution低剂量CT扫描定量评估与慢性阻塞性肺疾病严重程度的相关性研究. 医学信息. 2023(14): 125-128 . 百度学术
4. 郭建婷，龙怀聪. 慢性阻塞性肺疾病小气道的检测方法及研究进展. 国际呼吸杂志. 2022(14): 1109-1114 . 百度学术
5. 王挺年. 定量CT参数评价COPD疾病严重程度的研究. 中国现代医生. 2022(31): 60-63 . 百度学术
其他类型引用(1)
计量
- 文章访问数: 196
- HTML全文浏览量: 21
- PDF下载量: 7
- 被引次数: 6
下载:
