对比增强CT作为肝动脉放射栓塞中肺分流分数评估的无创替代方法。

Radiology advances Pub Date : 2025-08-04 eCollection Date: 2025-07-01 DOI:10.1093/radadv/umaf025
Brahim Mehadji, Talia Marx, Adrianna Carter, Roger Eric Goldman, Catherine Tram Vu, Emilie Roncali
{"title":"对比增强CT作为肝动脉放射栓塞中肺分流分数评估的无创替代方法。","authors":"Brahim Mehadji, Talia Marx, Adrianna Carter, Roger Eric Goldman, Catherine Tram Vu, Emilie Roncali","doi":"10.1093/radadv/umaf025","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Estimation of the lung shunt fraction (LSF) is an integral part of liver radioembolization treatment planning to prevent excessive lung irradiation from arterio-venous shunting in the liver. <sup>99m</sup>Tc macro-aggregated albumin (<sup>99m</sup>Tc-MAA) nuclear imaging is the standard method. Recent literature suggests that <sup>99m</sup>Tc-MAA nuclear imaging may be omitted in selected patient populations.</p><p><strong>Purpose: </strong>This study investigates the potential of contrast-enhanced computed tomography (CECT) as a non-invasive method for estimating LSF as an alternative for <sup>99m</sup>Tc-MAA nuclear imaging.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 30 consecutive patients who underwent <sup>90</sup>Y radioembolization between January 2015 and December 2024, where both four-phase CECT and <sup>99m</sup>Tc-MAA planar imaging were performed within one month of each other. Hypervascular tumor enhancement was identified on the CECT by subtracting the portal venous phase from the arterial phase and applying an intensity threshold. Additional perfusion characteristics were captured. Statistical analysis assessed the agreement between the CECT-derived volume ratios and the LSF values derived from <sup>99m</sup>Tc-MAA imaging.</p><p><strong>Results: </strong>The cohort consisted of 23 male and 7 female patients with a median age of 66 years (interquartile range: 58-71), diagnosed with hepatocellular carcinoma (<i>n</i> = 24), intrahepatic cholangiocarcinoma (<i>n</i> = 2), pancreatic neuroendocrine tumors (<i>n</i> = 2), metastatic colorectal cancer (<i>n</i> = 1), and lymphocyte carcinoma (<i>n</i> = 1). Regression of the hypervascular-tumor-to-perfused volume ratio on CECT against LSF from <sup>99m</sup>Tc-MAA imaging showed <i>R</i> <sup>2</sup> = 0.95 (<i>P</i> < .001). In contrast, the correlation between tumor volume and LSF was <i>R</i> <sup>2</sup> = 0.38 (<i>P</i> = .001). The root mean square error between the LSF estimated from CECT and that measured using <sup>99m</sup>Tc-MAA planar imaging was 3%.</p><p><strong>Conclusion: </strong>Hypervascular-tumor-to-perfused volume ratio computed from CECT may offer a suitable alternative to <sup>99m</sup>Tc-MAA nuclear imaging for LSF estimation in patients undergoing transarterial radioembolization.</p>","PeriodicalId":519940,"journal":{"name":"Radiology advances","volume":"2 4","pages":"umaf025"},"PeriodicalIF":0.0000,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429231/pdf/","citationCount":"0","resultStr":"{\"title\":\"Contrast-enhanced CT as a non-invasive alternative for lung shunt fraction estimation in hepatic transarterial radioembolization.\",\"authors\":\"Brahim Mehadji, Talia Marx, Adrianna Carter, Roger Eric Goldman, Catherine Tram Vu, Emilie Roncali\",\"doi\":\"10.1093/radadv/umaf025\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Estimation of the lung shunt fraction (LSF) is an integral part of liver radioembolization treatment planning to prevent excessive lung irradiation from arterio-venous shunting in the liver. <sup>99m</sup>Tc macro-aggregated albumin (<sup>99m</sup>Tc-MAA) nuclear imaging is the standard method. Recent literature suggests that <sup>99m</sup>Tc-MAA nuclear imaging may be omitted in selected patient populations.</p><p><strong>Purpose: </strong>This study investigates the potential of contrast-enhanced computed tomography (CECT) as a non-invasive method for estimating LSF as an alternative for <sup>99m</sup>Tc-MAA nuclear imaging.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 30 consecutive patients who underwent <sup>90</sup>Y radioembolization between January 2015 and December 2024, where both four-phase CECT and <sup>99m</sup>Tc-MAA planar imaging were performed within one month of each other. Hypervascular tumor enhancement was identified on the CECT by subtracting the portal venous phase from the arterial phase and applying an intensity threshold. Additional perfusion characteristics were captured. Statistical analysis assessed the agreement between the CECT-derived volume ratios and the LSF values derived from <sup>99m</sup>Tc-MAA imaging.</p><p><strong>Results: </strong>The cohort consisted of 23 male and 7 female patients with a median age of 66 years (interquartile range: 58-71), diagnosed with hepatocellular carcinoma (<i>n</i> = 24), intrahepatic cholangiocarcinoma (<i>n</i> = 2), pancreatic neuroendocrine tumors (<i>n</i> = 2), metastatic colorectal cancer (<i>n</i> = 1), and lymphocyte carcinoma (<i>n</i> = 1). Regression of the hypervascular-tumor-to-perfused volume ratio on CECT against LSF from <sup>99m</sup>Tc-MAA imaging showed <i>R</i> <sup>2</sup> = 0.95 (<i>P</i> < .001). In contrast, the correlation between tumor volume and LSF was <i>R</i> <sup>2</sup> = 0.38 (<i>P</i> = .001). The root mean square error between the LSF estimated from CECT and that measured using <sup>99m</sup>Tc-MAA planar imaging was 3%.</p><p><strong>Conclusion: </strong>Hypervascular-tumor-to-perfused volume ratio computed from CECT may offer a suitable alternative to <sup>99m</sup>Tc-MAA nuclear imaging for LSF estimation in patients undergoing transarterial radioembolization.</p>\",\"PeriodicalId\":519940,\"journal\":{\"name\":\"Radiology advances\",\"volume\":\"2 4\",\"pages\":\"umaf025\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-08-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12429231/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Radiology advances\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1093/radadv/umaf025\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/7/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology advances","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1093/radadv/umaf025","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/7/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:肺分流分数(LSF)的估计是肝脏放射栓塞治疗计划的重要组成部分,以防止肝脏动静脉分流引起的过度肺部照射。99mTc巨聚集白蛋白(99mTc- maa)核成像是标准方法。最近的文献表明,99mTc-MAA核成像可以在选定的患者群体中省略。目的:本研究探讨对比增强计算机断层扫描(CECT)作为估计LSF的一种非侵入性方法,作为99mTc-MAA核成像的替代方法。材料和方法:本单中心回顾性研究纳入了2015年1月至2024年12月连续30例接受90Y放射栓塞的患者,其中四期CECT和99mTc-MAA平面成像均在一个月内进行。在CECT上通过从动脉期减去门静脉期并应用强度阈值来识别高血管肿瘤。捕获其他灌注特征。统计分析评估cect得出的体积比与99mTc-MAA成像得出的LSF值之间的一致性。结果:该队列包括23名男性和7名女性患者,中位年龄为66岁(四分位数范围为58-71岁),诊断为肝细胞癌(n = 24),肝内胆管癌(n = 2),胰腺神经内分泌肿瘤(n = 2),转移性结直肠癌(n = 1)和淋巴细胞癌(n = 1)。99mTc-MAA显像CECT对LSF的高血管肿瘤与灌注体积比回归显示r2 = 0.95 (P r2 = 0.38 (P = 0.001)。CECT估计的LSF与使用99mTc-MAA平面成像测量的LSF之间的均方根误差为3%。结论:CECT计算的高血管肿瘤与灌注体积比可作为99mTc-MAA核显像的替代方案,用于评估经动脉放射栓塞患者的LSF。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Contrast-enhanced CT as a non-invasive alternative for lung shunt fraction estimation in hepatic transarterial radioembolization.

Contrast-enhanced CT as a non-invasive alternative for lung shunt fraction estimation in hepatic transarterial radioembolization.

Contrast-enhanced CT as a non-invasive alternative for lung shunt fraction estimation in hepatic transarterial radioembolization.

Contrast-enhanced CT as a non-invasive alternative for lung shunt fraction estimation in hepatic transarterial radioembolization.

Background: Estimation of the lung shunt fraction (LSF) is an integral part of liver radioembolization treatment planning to prevent excessive lung irradiation from arterio-venous shunting in the liver. 99mTc macro-aggregated albumin (99mTc-MAA) nuclear imaging is the standard method. Recent literature suggests that 99mTc-MAA nuclear imaging may be omitted in selected patient populations.

Purpose: This study investigates the potential of contrast-enhanced computed tomography (CECT) as a non-invasive method for estimating LSF as an alternative for 99mTc-MAA nuclear imaging.

Materials and methods: This single-center retrospective study included 30 consecutive patients who underwent 90Y radioembolization between January 2015 and December 2024, where both four-phase CECT and 99mTc-MAA planar imaging were performed within one month of each other. Hypervascular tumor enhancement was identified on the CECT by subtracting the portal venous phase from the arterial phase and applying an intensity threshold. Additional perfusion characteristics were captured. Statistical analysis assessed the agreement between the CECT-derived volume ratios and the LSF values derived from 99mTc-MAA imaging.

Results: The cohort consisted of 23 male and 7 female patients with a median age of 66 years (interquartile range: 58-71), diagnosed with hepatocellular carcinoma (n = 24), intrahepatic cholangiocarcinoma (n = 2), pancreatic neuroendocrine tumors (n = 2), metastatic colorectal cancer (n = 1), and lymphocyte carcinoma (n = 1). Regression of the hypervascular-tumor-to-perfused volume ratio on CECT against LSF from 99mTc-MAA imaging showed R 2 = 0.95 (P < .001). In contrast, the correlation between tumor volume and LSF was R 2 = 0.38 (P = .001). The root mean square error between the LSF estimated from CECT and that measured using 99mTc-MAA planar imaging was 3%.

Conclusion: Hypervascular-tumor-to-perfused volume ratio computed from CECT may offer a suitable alternative to 99mTc-MAA nuclear imaging for LSF estimation in patients undergoing transarterial radioembolization.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信