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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Abstract Full text Figures/Tables Video References Cited by

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. 任曉璇. 影像學檢查在肝癌介入術后療效評價中的現狀及進展. 中國介入影像與治療學, 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. 中華人民共和國衛生部. 原發性肝癌診療規范(2011年版). 臨床腫瘤學雜志, 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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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. 石潔, 王云玲, 聶聰科, 等. 雙源CT雙能量掃描在肝臟成像中的應用研究. 中國醫學計算機成像雜志, 2014, 20(3): 250-252.
11. 錢玉娥, 胡紅杰, 張峭巍, 等. 新雙源CT虛擬平掃技術在肝臟檢查中的應用. 中華放射學雜志, 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. 劉嶸, 王建華, 周康榮, 等. 原發性肝癌碘油栓塞后磁共振成像表現與病理的對照研究. 中華肝臟病雜志, 2005, 13(10): 754-758.
14. 王翔, 王濤, 王小琴, 等. 雙源CT雙能量掃描在肝臟腫瘤診斷中的應用價值探討. 當代醫學, 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. 王榮華, 武志峰, 鄂林寧, 等. 雙能量CT成像鑒別診斷淋巴瘤與轉移性淋巴結. 中國醫學影像技術, 2013, 29(7): 1175-1179.
18. 劉慧, 武志峰, 鄂林寧, 等. 雙能量碘圖在肝癌TACE術后療效評估中的應用價值. 影像診斷與介入放射學, 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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