[1]高瑞晖,陈勇,曾庆乐,等.DSA联合动态增强CT定量分析肝癌HAIC的疗效[J].中国医学物理学杂志,2024,41(7):858-863.[doi:DOI:10.3969/j.issn.1005-202X.2024.07.011]
　GAO Ruihui,CHEN Yong,et al.Efficacy evaluation of hepatic arterial infusion chemotherapy for liver cancer through quantitative analysis of digital subtraction angiography and dynamic contrast-enhanced CT[J].Chinese Journal of Medical Physics,2024,41(7):858-863.[doi:DOI:10.3969/j.issn.1005-202X.2024.07.011]
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DSA联合动态增强CT定量分析肝癌HAIC的疗效()
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《中国医学物理学杂志》[ISSN:1005-202X/CN:44-1351/R]

卷:
41卷
期数:
2024年第7期
页码:
858-863
栏目:
医学影像物理
出版日期:
2024-07-25

文章信息/Info

Title:
Efficacy evaluation of hepatic arterial infusion chemotherapy for liver cancer through quantitative analysis of digital subtraction angiography and dynamic contrast-enhanced CT
文章编号:
1005-202X（2024）07-0858-06
作者:
高瑞晖1; 2; 陈勇2; 曾庆乐2; 庞桦进2; 林坚1; 郝金华1
1.中山火炬开发区人民医院放射医学中心， 广东 中山 528437； 2.南方医科大学南方医院血管与介入科， 广东 广州 510515
Author(s):
GAO Ruihui1;  2;  CHEN Yong2;  ZENG Qingle2;  PANG Huajin2;  LIN Jian1;  HAO Jinhua1
1. Center of Radiology, Zhongshan Torch Development Zone Peoples Hospital, Zhongshan 528437, China 2. Department of Vascular and Interventional Therapy, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China
关键词:
经肝动脉灌注化疗; 原发性肝癌; 疗效分析; 数字减影血管造影; 动态增强CT
Keywords:
Keywords: hepatic artery infusion chemotherapy primary liver cancer efficacy analysis digital subtraction angiography dynamic contrast-enhanced CT
分类号:
R735.7；R811.1
DOI:
DOI:10.3969/j.issn.1005-202X.2024.07.011
文献标志码:
A
摘要:
目的：探讨DSA联合动态增强CT定量分析和评估肝癌经肝动脉灌注化疗（HAIC）的疗效。方法：临床诊断为原发性肝癌患者50例，均行3次以上HAIC治疗。根据第1次及第3次HAIC治疗前1周内的增强CT，按照改良实体瘤疗效评价标准分为疗效良好组（CR+PR）和疗效不佳组（SD+PD），比较两组治疗前和2次HAIC治疗后DSA造影肝癌的血流动力学参数［染色达峰时间（TP）、峰值密度（PV）、时间-密度曲线上升支斜率（SU）］及CT增强扫描肝癌各期CT值的变化，并进行敏感性分析。对有统计学差异的指标进行Logistic回归分析和ROC曲线分析，以评估判断肝癌HAIC疗效的效能。结果：治疗前，两组间CT值及DSA指标无显著差异（P>0.05）。所有患者均成功完成2次HAIC治疗。第3次HAIC治疗前1周的增强CT，疗效良好组的动脉期和静脉期CT值相比于治疗前显著降低（P<0.05），延时期CT值无显著差异（P>0.05）。第3次HAIC时DSA造影肝癌的血流动力学参数PV与SU显著降低，TP显著延长（P<0.05）。疗效不佳组各项指标差异不显著。回归分析显示，动脉期CT值和DSA造影SU值与疗效显著相关。ROC曲线结果显示，动脉期CT值和SU值是判断疗效的有效指标。结论：DSA造影的SU值和动态增强CT的CT值能够客观地反映HAIC后肝癌的血供变化，且与HAIC疗效相关，可作为评估HAIC疗效的影像学依据。
Abstract:
Abstract: Objective To investigate the value of the quantitative analysis of digital subtraction angiography (DSA) and dynamic contrast-enhanced CT in evaluating the efficacy of hepatic artery infusion chemotherapy (HAIC) for liver cancer. Methods Fifty patients who were clinically diagnosed with primary liver cancer and treated with HAIC at least 3 times were enrolled in the study. Based on the enhanced CT scans taken within 1 week before the 1st and 3rd HAIC, patients were divided into good response group (CR+PR) and poor response group (SD+PD) according to the modified response evaluation criteria in solid tumor. The hemodynamic parameters［time to peak (TP), peak density (PV), and slope of the rising edge of the time-density curve (SU)］ of liver cancer on DSA before treatment and after two HAIC, as well as the changes in the CT values of liver cancer in each phase of CT enhancement were compared, and then sensitivity analysis was conducted. Significant indicators were further analyzed with Logistic regression and ROC curve to assess their efficacies in evaluating HAIC response in liver cancer. Results The differences in pre-treatment CT values and DSA indicators between two groups were trivial (P>0.05). All patients successfully completed HAIC twice. The enhanced CT taken 1 week before the 3rd HAIC showed reductions in the arterial- and venous-phase CT values in good response group (P<0.05), while no significant difference was found in the delayed-phase CT value (P>0.05). At the 3rd HAIC, DSA angiography demonstrated significant reductions in PV and SU, and a significant prolongation of TP in good response group (P<0.05) while there were no significant differences in various indicators in poor response group. Regression analysis showed that arterial-phase CT values and DSA angiography SU were significantly correlated with therapeutic efficacy. ROC curve results indicated that arterial-phase CT values and SU were effective indicators for evaluating therapeutic efficacy. Conclusion The SU from DSA angiography and the CT values from dynamic contrast-enhanced CT which can objectively reflect the changes in blood supply of liver cancer after HAIC and are associated with HAIC efficacy can serve as radiological evidence for evaluating HAIC response.

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备注/Memo

备注/Memo:
【收稿日期】2024-01-13 【基金项目】中山市社会公益科技研究项目（2022B1114）；广东省科技计划项目（2012B010200027） 【作者简介】高瑞晖，副主任医师，研究方向：肝癌的诊断与介入治疗，E-mail: 361275969@qq.com 【通信作者】曾庆乐，博士，副主任医师，副教授，研究方向：肝癌及外周血管的介入治疗，E-mail: 443444572@qq.com
更新日期/Last Update: 2024-07-12