双能CT虚拟单能成像在直肠癌症放疗中的靶点描绘的评价
Evaluation of dual-energy CT virtual monoenergetic imaging for target delineation in rectal cancer radiotherapy.
摘要(中文译文)
评估双能量CT（DECT）虚拟单能成像（VMI）在直肠癌中的图像质量，并探讨其在放疗大体肿瘤体积（GTV）勾画中的价值。前瞻性纳入29例接受新辅助放化疗的直肠癌患者。每例患者于同一天接受增强DECT和3.0 T MRI检查。对40~200 keV的VMI及模拟120 kVp CT（S）评估病灶对比度（LC）、对比噪声比（CNR）和信噪比（SNR），并据此确定最佳单能图像（VMI）。三名放射肿瘤科医师独立评估VMI、S和T2WI-MRI的总体图像质量及肿瘤勾画情况，并勾画GTV。以T2WI-MRI作为参考。采用Dice相似系数（DSC）比较勾画性能，并进一步分析观察者间一致性和头尾侧边界识别情况。静脉期40 keV VMI（VMI）的LC、CNR和SNR均显著高于S（p < 0.0001）。VMI的主观评分在总体图像质量（p = 0.040）和肿瘤勾画（p = 0.449）方面与MRI相当。VMI与MRI定义的GTV之间的一致性显著高于S与MRI定义的GTV之间的一致性（平均DSC：0.83 ± 0.04 vs 0.67 ± 0.10，p < 0.0001）。在配准精度高的患者中，VMI-MRI比较的DSC进一步提高至0.86 ± 0.01。VMI的观察者间一致性优于S（0.82 ± 0.05 vs 0.76 ± 0.07，p < 0.001）。与S相比，使用VMI时头侧和尾侧边界误差也显著减小。静脉期40 keV DECT VMI在客观和主观图像质量方面均优于S，显著提高了GTV勾画准确性、观察者间一致性和头尾侧边界识别能力。它可能作为一种可靠的影像学工具，在直肠癌放疗中平衡肿瘤控制与正常组织保护。
Abstract
To evaluate the image quality of dual-energy CT (DECT) virtual monoenergetic imaging (VMI) in rectal cancer and to investigate its value for gross tumor volume (GTV) delineation in radiotherapy. Twenty-nine patients with rectal cancer receiving neoadjuvant chemoradiotherapy were prospectively enrolled. Each patient underwent contrast-enhanced DECT and 3.0 T MRI on the same day. Lesion contrast (LC), contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) were assessed for VMI from 40-200 keV and synthetic 120 kVp CT (S), with the optimal monoenergetic image (VMI) determined accordingly. Three radiation oncologists independently assessed VMI, S, and T2WI-MRI for overall image quality and tumor delineation, and delineated GTVs. T2WI-MRI served as the reference. Dice similarity coefficient (DSC) was used to compare delineation performance, with further analysis of interobserver agreement and cranial-caudal margin identification. Venous-phase 40 keV VMI (VMI) showed significantly higher LC, CNR, and SNR than S (p < 0.0001). Subjective scores of VMI were comparable with MRI for both overall image quality (p = 0.040) and tumor delineation (p = 0.449). The concordance between VMI- and MRI-defined GTVs was significantly higher than that between S- and MRI-defined GTVs (mean DSC: 0.83 ± 0.04 vs 0.67 ± 0.10, p < 0.0001). In patients with high registration accuracy, the DSC for the VMI-MRI comparison further improved to 0.86 ± 0.01. Interobserver agreement was superior for VMI compared with S (0.82 ± 0.05 vs 0.76 ± 0.07, p < 0.001). Cranial and caudal margin errors were also significantly reduced when using VMI compared to S. Venous-phase 40 keV DECT VMI demonstrated objectively and subjectively superior image quality compared with S, significantly improving GTV delineation accuracy, interobserver consistency, and cranial-caudal margin identification. It may serve as a reliable imaging tool to balance tumor control and normal tissue sparing in rectal cancer radiotherapy.
如何引用
AMA
Kai Liu, Weiping Wang, Peng Wang, Xi Qi, Yuchen Zhou, Dingchao Liu, et al. Evaluation of dual-energy CT virtual monoenergetic imaging for target delineation in rectal cancer radiotherapy.. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2026; doi:10.1016/j.radonc.2026.111488.
APA
Kai Liu, Weiping Wang, Peng Wang, Xi Qi, Yuchen Zhou, Dingchao Liu, et al (2026). Evaluation of dual-energy CT virtual monoenergetic imaging for target delineation in rectal cancer radiotherapy.. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. https://doi.org/10.1016/j.radonc.2026.111488
GB/T 7714
Kai Liu, Weiping Wang, Peng Wang, Xi Qi, Yuchen Zhou, Dingchao Liu, et al. Evaluation of dual-energy CT virtual monoenergetic imaging for target delineation in rectal cancer radiotherapy.[J]. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2026 doi:10.1016/j.radonc.2026.111488.
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