The Study Of Gemstone Spectral Imaging On The Evaluation Of Primary Hepatocellular Carcinoma After Treatment With TACE

ObjectiveTo explore the clinical application value of gemstone spectral imaging (GSI) in the diagnosis of Primary Hepatocellular Carcinoma (PHC) after treatment with Transcatheter Arterial Chemoembolization(TACE).MethodsAgent to collect in May 2014 to March 2015 in our hospital in room received transcatheter hepatic artery chemoembolization with conventional treatment of 32 cases of primary liver cancer patients. Use of Gemstone Spectral Imaging CT for 32 patients with PHC after treatment with TACE with conventional spectral scan were studied, GSI Viewer was applied to acquire iodine-based image,70 keV monochromatic images and conventional polychromatic images (120kVp). At GE AW4.6 browser workstation through spectroscopy (GSI Viewer) use mixed energy image and single images are respectively using multi planar reconstruction (MPR), subjective image quality were used to compare differences between the two modes. The lesions were observed, that subjective ratings was mainly from the number of lesions, strengthen the situation. Statistical methods using matching t test, in order to P<0.05 for statistical significance. While leveraging GSI image analysis tools, CNR curve on the workstation through the use of spectrum browser optimum single energy value, And the use of spectrum curve analysis tissue components of the lesion iodized oil defect. Cases of CT is more reliable, again with intraoperative DSA imaging results by comparing with conventional gold standard group, two groups of two reconstruction methods calculating income (GSI, QC group) sensitivity, specific degrees and accuracy.ResultsAgent after analyzing CNR curve can found 70 kev single value image display embolism were the best, so in 70 kev can single value reconstruction images for the next step research. Different ROI lipiodol embolism lesion defect corresponding spectra curve Traveling to diagnose the presence or absence of residual tumor of significance, If spectrum curve and the preoperative lesions or clear residual disease spectrum similar curve comparison, Indicates that the ROI component of viable tissue. In terms of component spectrum curve similar necrosis, compared necrosis ingredients. The experimental results under different imaging methods embolism lesion to enhance the defect showed statistically significant differences, and the GSI group analysis of the image obtained is higher than average QC group method. Compared with polychromatic images, subjective image quality were higher in monochromatic images, (1.27 ±0.83)and(0.77±0.68), t=2.56, P<0.05, that the difference was statistically significant. The results with DSA as the gold standard control, GSI CT imaging in 32 patients with TACE in patients after reexamination, make a definite diagnosis in 30 eases,48 lesions were detected, diagnostic sensitivity of disease 85.16%, a specificity of 90.48%, positive predictive value of 92.00%, negative predictive value of 82.61%. average QC group method in 32 patients with TACE in patients after reexamination, make a definite diagnosis in 24 eases,35 lesions were detected, diagnostic sensitivity of disease 61.11%, a specificity of 76.47%, positive predictive value of 73.33%, negative predictive value of 65.00%. Conclusion Relatively conventional CT imaging, GSI 70 keV monochromatic images can more clearly show after TACE in PHC postoperative iodine oil deposit defect with conventional reinforcement, improve the lesion detection rate of survival or recurrence, provide more accurate diagnostic information for clinical, help for further treatment.