双能 CT 预测胰腺导管腺癌术后早期复发的效率评估。

IF 2.8 2区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Pancreatology Pub Date : 2024-11-01 DOI:10.1016/j.pan.2024.09.012

Si-Yao Yu , Yu-Ping Shu , Xiao-Han Bai , Jing Yu , Zi-Peng Lu , Kui-Rong Jiang , Qing Xu

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引用次数: 0

摘要

目的评估双能 CT（DECT）定量参数和基本 CT 特征在预测胰腺导管腺癌（PDAC）术后早期复发（ER）方面的效果：在这项研究中，纳入了2018年至2022年接受根治性切除术和DECT的PDAC患者，并将其分为ER组和非ER组。分析了所有患者的临床数据、基本 CT 特征和 DECT 参数。通过 Logistic 回归分析确定了 ER 的独立预测因素。建立了三个模型（模型 A：CT 基本特征；模型 B：DECT 参数；模型 C：CT 基本特征 + DECT 参数）。利用接收者操作特征曲线分析评估预测性能：共有 150 名患者入选（ER 组：n = 63；非 ER 组：n = 87）。边缘增强（几率比 [OR]，3.32）、胰周股线外观（OR，2.68）、胰腺实质期电子密度（P-Rho；OR，0.90）、动脉增强分数（AEF；OR，0.05）和延迟期胰腺实质脂肪分数（OR，1.25）被确定为ER的独立预测指标。模型 C 的曲线下面积最高，为 0.898。此外，对可切除和边缘可切除的PDAC亚组分别确定了相应的ER风险因素：结论：DECT定量参数可对PDAC患者的术后ER进行无创预测，DECT参数和基本CT特征的组合显示出较高的预测效率。我们的模型有助于识别具有高危因素的患者，为术前决策提供指导。

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Efficiency evaluation of dual-energy CT to predict the postoperative early recurrence of pancreatic ductal adenocarcinoma

Objectives

To evaluate the efficacy of quantitative parameters from dual-energy CT (DECT) and basic CT features in predicting the postoperative early recurrence (ER) of pancreatic ductal adenocarcinoma (PDAC).

Methods

In this study, patients with PDAC who underwent radical resection and DECT from 2018 to 2022 were enrolled and categorised into ER and non-ER groups. The clinical data, basic CT features and DECT parameters of all patients were analyzed. Independent predictors of ER were identified with Logistic regression analyses. Three models (model A: basic CT features; model B: DECT parameters; model C: basic CT features + DECT parameters) were established. Receiver operating characteristic curve analysis was utilized to evaluate predictive performance.

Results

A total of 150 patients were enrolled (ER group: n = 63; non-ER group: n = 87). Rim enhancement (odds ratio [OR], 3.32), peripancreatic strands appearance (OR, 2.68), electron density in the pancreatic parenchymal phase (P-Rho; OR, 0.90), arterial enhancement fraction (AEF; OR, 0.05) and pancreatic parenchyma fat fraction in the delayed phase (OR, 1.25) were identified as independent predictors of ER. Model C showed the highest area under the curve of 0.898. In addition, the corresponding ER risk factors were identified separately for resectable and borderline resectable PDAC subgroups.

Conclusions

DECT quantitative parameters allow for the noninvasive prediction of postoperative ER in patients with PDAC, and the combination of DECT parameters and basic CT features shows a high prediction efficiency. Our model can help to identify patients with high-risk factors to guide preoperative decision making.

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来源期刊

Pancreatology 医学-胃肠肝病学

CiteScore

7.20

自引率

5.60%

发文量

194

审稿时长

44 days

期刊介绍： Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.