CT灌注成像技术对晚期宫颈癌同步放化疗疗效的预测

To Predict the Efficacy of Concurrent Chemoradiotherapy for Advanced Cervical Cancer by CT Perfusion Imaging

摘要: 目的：分析多层螺旋CT灌注成像对中晚期宫颈癌放化疗治疗疗效的预测价值。方法：本研究选取2021年1月至2022年6月于郑州大学第二附属医院就诊，病理分期为IIB~IV期的120例宫颈癌作为研究对象，且患者具有完整的临床及影像资料。所有患者均接受完整的同步放化疗治疗方案，治疗前后行MRI检查并对肿瘤病灶感兴趣区(ROI)勾画，根据肿瘤消退率(RS)将患者分为治疗有效组83例、无效组37例。分析两组宫颈癌患者治疗前、后CT病灶不同灌注参数(BV, BF, PS, MTT)差异性，并采用受试者工作特征ROI曲线分析各参数对宫颈癌同步放化疗疗效的预测价值。结果：随着放化疗的有效进展，有效组宫颈癌病灶同步放化疗后BV、BF灌注参数水平明显低于治疗前。与治疗前有明显差异性，且同步放化疗有效组BV、BF值明显高于无效组宫颈癌患者CT灌注参数水平，差距具有统计学意义。BV、BF值越高，放化疗疗效越好。结论：基于CT灌注成像BV、BF等参数对中晚期宫颈癌同步放化疗疗效有一定的预测价值。

Abstract: Objective: To analyze the predictive value of multi-slice spiral CT perfusion imaging for the efficacy of chemoradiotherapy for advanced cervical cancer. Methods: A total of 120 patients with cervical cancer at stage IIB~IV who were treated in the Second Affiliated Hospital of Zhengzhou University from January 2021 to June 2022 were selected as the research subjects. The patients had complete clinical and imaging data. All patients underwent complete concurrent chemoradiotherapy. MRI examinations were carried out before and after the treatment, and the region of interest (ROI) of the tumor was delineated. The differences in various perfusion parameters (BV, BF, PS, MTT) of CT lesions before and after the treatment in the two groups of patients with cervical cancer were analyzed, and the receiver operating characteristic (ROC) curve was employed to analyze the predictive value of each parameter for the efficacy of concurrent chemoradiotherapy. Results: With the effective advancement of chemoradiotherapy, the BV and BF perfusion parameters of cervical cancer lesions in the effective group after concurrent chemoradiotherapy were notably lower than those before treatment. The BV and BF values in the effective group were significantly higher than those in the ineffective group, and the difference was statistically significant. The higher the BV and BF values, the more effective the chemoradiotherapy. Conclusion: BV, BF and other parameters based on CT perfusion imaging have certain predictive value for the efficacy of concurrent chemoradiotherapy in advanced cervical cancer.