This study investigated whether virtual monoenergetic images (VMIs) and iodine mapping based on dual-energy CT (DECT) provide advantages in the assessment of endometrial cancer. A dual-source DECT was performed for primary staging of histologically proven endometrioid adenocarcinoma in 21 women (66.8 ± 12.0 years). In addition to iodine maps, VMIs at 40, 50, 60, 70, and 80 keV were reconstructed from polyenergetic images (PEIs). Objective analysis comprised the measurement of tumor contrast, contrast-to-noise ratio, and normalized iodine concentration (NIC). In addition, three radiologists independently rated tumor conspicuity. The highest tumor contrast (106.6 ± 45.0 HU) and contrast-to-noise ratio (4.4 ± 2.0) was established for VMIs at 40 keV. Tumor contrast in all VMIs ≤ 60 keV was higher than in PEIs (p< 0.001). The NIC of malignant tissue measured in iodine maps was substantially lower compared with a healthy myometrium (0.3 ± 0.1 versus 0.6 ± 0.1 mg/mL;p< 0.001). Tumor conspicuity was highest in 40 keV datasets, whereas no difference was found among PEIs and VMIs at 60 and 70 keV (p≥ 0.334). Interobserver agreement was good, indicated by an intraclass correlation coefficient of 0.824 (0.772–0.876;p< 0.001). In conclusion, computation of VMIs at 40 keV and color-coded iodine maps aids the assessment of endometroid adenocarcinoma in primary staging.
本研究探讨了基于双能CT（DECT）的虚拟单能谱图像（VMIs）与碘图在子宫内膜癌评估中是否具有优势。研究对21例经组织学证实为子宫内膜样腺癌的女性患者（年龄66.8±12.0岁）进行了双源DECT原发分期扫描。除碘图外，还从多能谱图像（PEIs）重建出40、50、60、70和80 keV的VMIs。客观分析包括测量肿瘤对比度、对比噪声比和标准化碘浓度（NIC）。此外，三名放射科医师独立评估了肿瘤显著性。结果显示，40 keV VMI的肿瘤对比度（106.6±45.0 HU）和对比噪声比（4.4±2.0）最高。所有≤60 keV的VMIs中肿瘤对比度均高于PEIs（p<0.001）。碘图中恶性组织的NIC显著低于健康肌层（0.3±0.1对比0.6±0.1 mg/mL；p<0.001）。肿瘤显著性在40 keV数据集中最高，而PEIs与60及70 keV VMIs之间无显著差异（p≥0.334）。观察者间一致性良好，组内相关系数为0.824（0.772–0.876；p<0.001）。综上所述，40 keV VMI的计算与彩色编码碘图有助于子宫内膜样腺癌的原发分期评估。
肿瘤(癌症)患者之家