双层探测器光谱CT定量参数在鉴别诊断非小细胞肺癌与小细胞肺癌中的应用

Application of Dual-layer Spectral Detector CT Quantification Parameters in Differential Diagnosis of Non Small Cell Lung Cancer Versus Small Cell Lung Cancer

目的:探讨双层探测器光谱CT定量参数在鉴别诊断非小细胞肺癌(NSCLC)与小细胞肺癌(SCLC)的应用价值。方法:回顾性分析125例在双层探测器光谱CT完成胸部增强扫描的肺癌患者,根据病理结果分为NSCLC组(n=90)与SCLC组(n=35)。测量两组动静脉期40~100keV(间隔10keV)共7个单能量CT值、碘浓度(IC)、有效原子序数(Z_(eff))、标准化碘浓度(NIC)及能谱曲线斜率(K_(40-100keV))等参数。应用独立样本t检验或Mann-Whitney U检验对两组数据进行统计学分析。用有统计学意义的数据绘制受试者工作特征曲线(ROC),得出曲线下面积(AUC),分析各能谱CT参数鉴别诊断NSCLC与SCLC的效能。结果:动脉期NSCLC组40keV与50keV单能量CT值、IC、NIC、Z_(eff)及K_(40-100keV)的数值均大于SCLC组差异有统计学意义(P<0.05)。静脉期NSCLC组40~90keV(间隔10keV)共6个单能量CT值、IC、NIC、Z_(eff)及K_(40-100keV)的数值均大于SCLC组差异有统计学意义(P<0.05)。根据上述有统计学意义的数据得出ROC曲线诊断NSCLC与SCLC的AUC均>0.6,其中静脉期K_(40-100keV)的AUC最大为0.692,诊断阈值为1.56,灵敏度76.7%,特异度65.7%。结论:双层探测器光谱CT定量参数在鉴别诊断非小细胞肺癌与小细胞肺癌的应用中具有一定的价值。

Objective:To explore the application value of dual-layer spectral detector CT quantitative parameters in the differential diagnosis of non-small cell lung cancer(NSCLC)and small cell lung cancer(SCLC).Methods:A retrospective analysis of 125 lung cancer patients who completed an enhanced chest scan at dual-layer spectral detector CT,According to the pathological results,it was divided into NSCLC group(n=90)and SCLC group(n=35).Measuring the two groups of Arterial phase and Venous phase 40~100 keV monochromatic CT values(interval of 10 keV,A total of 7 monochromatic CT values),iodine concentration(IC),Z-effective(Z_(eff)),normalized iodine concentrations(NIC)and Slope of spectral HU curve(K_(40-100 keV)).Statistical analysis of both data groups was performed using an independent sample t-test or a Mann-Whitney U test.The receiver operating characteristic curve(ROC)was drawn with statistically significant data to obtain the area under the curve(AUC),and the efficacy of each spectral CT parameter in differential diagnosis of NSCLC and SCLC was analyzed.Results:In arterial phase,the values of 40 keV monochromatic CT and 50 keV monochromatic CT,IC,NIC,Z_(eff) and K_(40-100 keV) in NSCLC group were significantly greater than those in SCLC group(P<0.05).In venous phase,the values of 40~90 keV monochromatic CT values(interval of 10 keV,A total of 6 monochromatic CT values),IC,NIC,Z_(eff) and K_(40-100 keV) in the NSCLC group were significantly greater than those in the SCLC group(P<0.05).According to the above statistically significant data,the AUC of both NSCLC and SCLC diagnosed by ROC curve was>0.6.Among them,the maximum AUC of Venous phase K_(40-100 keV) was 0.692,with a diagnostic threshold of 1.56,sensitivity of 76.7%,and specificity of 65.7%.Conclusion:dual-layer spectral detector CT quantitative parameters have some value in the differential diagnosis of NSCLC from SCLC.