Abstract：ObjectiveTo explore the value of Gemstone spectral CT in the evaluation of stereotactic radiotherapy pretreatment in patients with nonsmall cell lung cancer (NSCLC). MethodsFifty patients with NSCLC (34 cases of adenocarcinoma, 15 cases of squamous cell carcinoma, and 1case of large cell undifferentiated carcinoma) who underwent Gemstone spectral CT scan at the department of Medical Imaging of Shandong Provincial Qianfoshan Hospital from June 2015 to December 2017 were selected. The region-of-interest for a given spatial placement of the tumors was set. The iodine density in the arterial phase and the maximum diameter of the tumor were measured. T test for two independent samples was used to compare the differences of iodine density in tumors with different pathological types and different air contents (44 cases of solid tumors, 6 cases of ground-glass opacity). The cases were divided into 3 groups according to the tumor maximum diameter（d）:d≤2cm group (n=18), 2＜d≤3cm group (n=12) and d＞3cm group (n=20). The differences of iodine density between the three groups were compared and they were separately compared by one-way ANOVA. Spearman correlation was used to analyze the relationship between iodine density and tumor maximum diameter. ResultsThere was no significant difference in the iodine density between adenocarcinoma and squamous cell carcinoma ［（21-71±4-12）×100mg/L，（21-29±3-93）×100mg/L，t=0-24,P＞0-05］. And there was no significant difference in the iodine density between solid tumors and groundglass opacity［（19-81±6-89）×100mg/L,（18-27±3-01）×100mg/L,t=0-54,P＞0-05］. The iodine density of d≤2cm group, 2＜d≤3cm group and d＞3cm group were（23-12±5-35）×100mg/L,（19-10±3-33）×100mg/L,（13-90±5-99）×100mg/L, respectively. The difference between three groups was statistically significant (F=14-62,P＜0-01). With the size of tumor increased, the iodine density decreased significantly (r=-0-71,P＜0-05). ConclusionsWith the tumor enlarges, the iodine density in the tumor decreases, which may be related to the relatively decreased blood volume of the tumor. The iodine density may be a non-invasive and quantitative assessment of the radio-resistance ascribable to the hypoxic cell population in a tumor, which may indicate the prognosis of radiotherapy to some extent.
苑呈秀 盛华强 王广丽 张添钰. 能谱CT在非小细胞肺癌立体定向放疗预处理评估中的应用价值[J]. 中华诊断学电子杂志, 2019, 7(1): 7-10.
Yuan Chengxiu1,2, Sheng Huaqiang2, Wang Guangli2, Zhang Tianyu1,2. The value of spectral CT in the pretreatment evaluation of stereotactic radiotherapy for non-small cell lung cancer. zhzdx, 2019, 7(1): 7-10.
