宝石CT能谱检查在肺腺癌同步放化疗患者治疗效果评估中的应用价值

Role of gemstone spectral CT in evaluating the therapeutic effect of synchronous radiotherapy and chemotherapy on lung adenocarcinoma

目的探讨宝石CT能谱检查评估肺腺癌同步放化疗患者治疗效果的价值。方法回顾性分析2021年6月至2023年6月聊城市第三人民医院收治的68例肺腺癌患者的临床资料,所有患者均接受同步放化疗,且在治疗后接受宝石CT能谱检查,评估所有患者治疗效果,根据结果分为有效组与无效组,比较有效组与无效组患者的宝石CT能谱检查参数,分析宝石CT能谱检查参数评估肺腺癌同步放化疗患者治疗效果的价值。结果治疗后,68例患者中有效41例,无效27例;其中完全缓解5例,部分缓解36例,稳定20例,进展7例,总缓解率为60.29%(41/68)。治疗无效组CT值、肿瘤最大径、动脉期能谱曲线斜率(λHU)、静脉期λHU、动脉期碘密度值(IC)、静脉期IC均高于有效组(P<0.05)。绘制受试者工作特征曲线结果显示,宝石CT能谱检查的肿瘤最大径、CT值、动脉期IC、静脉期IC、动脉期λHU、静脉期λHU评估肺腺癌同步放化疗患者治疗效果的曲线下面积均>0.70,评估价值理想,且以联合评估价值最佳。结论宝石CT能谱检查参数可评估肺腺癌同步放化疗患者治疗效果,当CT值、肿瘤最大径、动脉期λHU、静脉期λHU、动脉期IC、静脉期IC越高,提示肺腺癌同步放化疗患者治疗无效风险越高。

ObjectiveTo investigate the value of gemstone spectral computed tomography(CT)examination in evaluating the therapeutic effect of synchronous radiotherapy and chemotherapy on patients with lung adenocarcinoma.MethodsThe clinical data of 68 patients with lung adenocarcinoma admitted to the Third People Hospital in Liaocheng from June 2021 to June 2023 were retrospectively analyzed.All patients were treated by synchronous radiotherapy and chemotherapy;and they underwent gemstone spectral CT examination after treatment to evaluate the treatment effect of all patients.According to the results,they were divided into the effective group and the ineffective group.The gemstone spectral CT parameters were compared between the effective group and ineffective group.The significance of gemstone spectral CT examination parameters in evaluating the treatment effect of synchronous radiotherapy and chemotherapy on lung adenocarcinoma was analyzed.ResultsAmong the 68 patients,the therapy was effective for 41 case,and ineffective for 27 cases after treatment.There were 5 cases of complete remission,36 cases of partial remission,20 cases of stability,and 7 cases of progression among the 68 patients,with a total remission rate of 60.29%(41/68).CT value,tumor major diameter,slope of energy spectrum curve(λHU)in arterial phase,λHU in venous phase,iodine content(IC)in arterial phase,and IC in venous phase of the ineffective group were higher than those of the effective group(P<0.05).According to receiver operating characteristic curve drown,the area under the curve of parameters detected by gemstone spectral CT examination,including tumor major diameter,CT value,IC in arterial phase,IC in venous phase,λHU in arterial phase,andλHU in venous phase,in evaluating the therapeutic effect of synchronous radiotherapy and chemotherapy on lung adenocarcinoma were all greater than 0.70,indicating ideal evaluation value;and the combination of these parameters had the best evaluation value.ConclusionsGemstone spectral CT examination parameters can evaluate the therapeutic effect of synchronous radiotherapy and chemotherapy on lung adenocarcinoma.The risk of ineffective outcome of synchronous radiotherapy and chemotherapy for lung adenocarcinoma is positively correlated with the levels of CT value,tumor major diameter,λHU in arterial phase,λHU in venous phase,IC in arterial phase,and IC in venous phase.