The value of iodine overlay image technique based on dual-source CT dual-energy for the diagnosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients_West China Medical Journal

Authors：

 CHENG Guotao , ZHENG Yi , WANG Shengzhong , KONG Shubing , YANG Tao

Department of Radiology, Xianning Central Hospital, the First Affiliated Hospital of Hubei University of Science and Technology, Xianning, Hubei 437100, P. R. China;

Corresponding author：

CHENG Guotao, Email: 30687034@qq.com

Keywords：

Iodine overlay image; Dual-energy CT; Beam-hardening artifact; Transcatheter arterial chemoembolization

DOI：

10.7507/1002-0179.201910205

Video：

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Objective To explore the value of iodine overlay image technique based on dual-source CT dual-energy for the diagnosis in the primary hepatocellular carcinoma patients undergoing transcatheter arterial chemoembolization (TACE). Methods The imaging data of patients with primary hepatocellular carcinoma after TACE treatment from September 2015 to November 2018 were retrospectively analyzed. All patients completed dual-source CT dual-energy examination and digital subtraction angiography (DSA). The imaging data of the patients were analyzed by conventional linear blending images and iodine overlay image. The results of DSA were taken as the gold standard. The data indexes measured by the two imaging methods were compared. The consistency between the two imaging methods and DSA was determined by Kappa statistics. Results A total of 31 patients were included, and 57 nodes were found under DSA examination. The image quality evaluation (P<0.05), sensitivity (95.35% vs. 69.77%), specificity (92.86% vs. 64.29%), accuracy (94.74% vs. 68.42%), positive predictive value (97.62% vs. 85.71%) and negative predictive value (86.67% vs. 40.91%) of iodine overlay images were higher than those of conventional linear blending images. The consistency between conventional linear blending images and DSA was low (Kappa=0.286, P=0.023), and the consistency between iodine overlay images and DSA was excellent (Kappa=0.861, P<0.001). Conclusions Iodine overlay image could avoid the iodide artifact effectively and evaluate the abnormal enhancement quantitatively and qualitatively in patients undegoing TACE. This method could obtain more information to help diagnose in clinical and evaluate the postoperative efficacy of TACE accurately and objectively.

Citation： CHENG Guotao, ZHENG Yi, WANG Shengzhong, KONG Shubing, YANG Tao. The value of iodine overlay image technique based on dual-source CT dual-energy for the diagnosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients. West China Medical Journal, 2021, 36(9): 1221-1226. doi: 10.7507/1002-0179.201910205 Copy

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1. Bosch FX, Ribes J, Díaz M, et al. Primary liver cancer: worldwide incidence and trends. Gastroenterology, 2004, 127(Suppl 1): S5-S16.
2. 任晓璇. 影像学检查在肝癌介入术后疗效评价中的现状及进展. 中国介入影像与治疗学, 2010, 7(6): 672-675.
3. Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis, 2010, 30(1): 52-60.
4. 中华人民共和国卫生部. 原发性肝癌诊疗规范(2011年版). 临床肿瘤学杂志, 2011, 16(10): 929-946.
5. Graser A, Johnson TR, Chandarana H, et al. Dual energy CT: preliminary observations and potential clinical applications in the abdomen. Eur Radiol, 2009, 19(1): 13-23.
6. Behrendt FF, Schmidt B, Plumhans C, et al. Image fusion in dual energy computed tomography: effect on contrast enhancement, signal-to-noise ratio and image quality in computed tomography angiography. Invest Radiol, 2009, 44(1): 1-6.
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8. 柴瑞梅, 任克, 曲胜, 等. 双源CT双能量成像在肝癌经皮肝动脉化疗栓塞术后复查中的应用价值. 中华放射学杂志, 2011, 45(10): 980-984.
9. Yeh BM, Shepherd JA, Wang ZJ, et al. Dual engery and low-kVp CT in the abdomen. AJR Am J Roentgenol, 2009, 193(1): 47-54.
10. 石洁, 王云玲, 聂聪科, 等. 双源CT双能量扫描在肝脏成像中的应用研究. 中国医学计算机成像杂志, 2014, 20(3): 250-252.
11. 钱玉娥, 胡红杰, 张峭巍, 等. 新双源CT虚拟平扫技术在肝脏检查中的应用. 中华放射学杂志, 2011, 45(2): 120-123.
12. Vogl TJ, Schulz B, BauerRW, et al. Dual-energy CT applications in head and neck imaging. AJR Am J Roentgenol, 2012, 199(Suppl 5): S34-S39.
13. 刘嵘, 王建华, 周康荣, 等. 原发性肝癌碘油栓塞后磁共振成像表现与病理的对照研究. 中华肝脏病杂志, 2005, 13(10): 754-758.
14. 王翔, 王涛, 王小琴, 等. 双源CT双能量扫描在肝脏肿瘤诊断中的应用价值探讨. 当代医学, 2012, 18(29): 77-79.
15. Brown CL, Hartman RP, Dzyubak OP, et al. Dual-energy CT iodine overlay technique for characterization of renal masses as cyst or solid: a phantom feasibility study. Eur Radiol, 2009, 19(5): 1289-1295.
16. Ascenti G, Mileto A, Krauss B, et al. Distinguishing enhancing from nonenhancing renal masses with dual-source dual-energu CT: iodine quantification versus stangard enhance-ment measurements. Eur Radiol, 2013, 23(8): 2288-2295.
17. 王荣华, 武志峰, 鄂林宁, 等. 双能量CT成像鉴别诊断淋巴瘤与转移性淋巴结. 中国医学影像技术, 2013, 29(7): 1175-1179.
18. 刘慧, 武志峰, 鄂林宁, 等. 双能量碘图在肝癌TACE术后疗效评估中的应用价值. 影像诊断与介入放射学, 2015, 24(2): 113-117.

West China Medical Journal

The value of iodine overlay image technique based on dual-source CT dual-energy for the diagnosis after transcatheter arterial chemoembolization in hepatocellular carcinoma patients

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