The Preliminary Research Of Primary Hepatic Carcinoma Patients After The Transcatheter Arterial Chemoembolization Observed By Spectral CT Imaging

Objective:To evaluate the efficacy of primary hepatic carcinoma patients with transcatheter arterial chemoembolization(TACE) by spectrum CT scanning before and after treatment combined with clinical sensitivity index of alpha fetoprotein(AFP) trend, analyze the observation value of the spectrum CT single energy CT value and material separation image of hepatocellular carcinoma hepatic arterial embolization with chemotherapy treatment.Methods:select 30 cases of patients with primary liver cancer from our hospital confirmed by imaging examination and laboratory examination all the patients before AFP is more than or equal to 200ng/ml, and the first treatment for interventional therapy. Before and 4--8weeks after hepatic artery embolism chemotherapy all cases underwent the energy spectrum of CT enhancement scanning. The energy spectrum of CT post processing software were used for data analysis, those were measured before and after the treatment of lesion lipiodol deposition area of different single energy(40--140 Kev, interval 10Kev)lesions in portal phase changes and CT value of the region of interest(ROI) of iodine content, standardized iodine content in iodine content(lesions take the initiative with the same layer of iodine content of abdominal vein ratio), the changes of the water content,combined with the changes of AFP before and after treatment,. Statistical analysis were done for all results.Results:30 cases of patients with primary liver cancer after TACE treatment, according to the proportion of AFP decreased, were divided into AFP response group(AFP after operation compared with the preoperative baseline by more than 20%)( 17 cases), AFP non response group(AFP after operation compared with the preoperative baseline decreased <20%)(13 cases). The CT value under each single energy in AFP response group before and after treatment(40Kev-140 Kev, interval 10Kev) were: 191.96 + 12.78 and 170.73 + 12.86(HU),143.27 + 9.93 and 131.29 + 6.68(HU), 105.52 + 10.46 and 94.76 + 9.67(HU), 86.08 +5.98 and 77.09 + 5.62(HU), 72.76 + 4.40 and 64.81 + 4.27(HU), 63.58 + 4.78 and 57.90+ 4.89(HU), 56.14 + 4.37 and 51.50 + 3.91(HU), 51.05 + 2.31 and 46.91 + 2.77(HU),46.63 + 2.14 and 42.38 + 2.25(HU), 42.78 + 1.70 and 39.54 + 1.74(HU), 41.12 + 1.28 and 38.40 + 1.10(HU). Those in AFP non responder groups were: 181.34 + 16.95 and174.23 + 11.86(HU), 140.77 + 10.70 and 137.88 + 9.41(HU), 103.23 + 9.59 and 100.31 +10.30(HU), 82.23 + 8.27 and 79.92 + 6.74(HU), 71.27 + 4.78 and 69.57 + 5.05(HU),60.42 + 5.97 and 59.58 + 6.40(HU), 54.99 + 5.26 and 54.15 + 5.23(HU), 51.61 + 2.45 and 50.48 + 2.08(HU), 46.74 + 2.48 and 45.58 + 3.02(HU), 42.59 + 1.95 and 41.14 +3.40(HU), 40.77 + 1.40 and 40.28 + 1.35(HU). After the paired t-test for the two sets of data no statistical differences only happened at 120Kev(p=0.063) and 130Kev(p=0.080)in the AFP non responder group, others had statistical significance. Non parametric test was done between the AFP response group and AFP non response group for each single energy CT value, medians from AFP response group difference were greater than that from AFP non responder group. The iodine content, standard iodine content, water content of non iodized oil deposition area before and after treatment in the AFP response group are respectively: 18.48 + 1.25 and 16.02 + 1.95(100ug/ml), 0.43 + 0.02 and 0.38 + 0.04,1036.94 + 3.09 and 1036.35 + 3.10(100ug/ml). And the data in AFP non response group before and after treatment are : 18.63 + 1.24 and 17.79 + 1.17(100ug/ml), 0.43 + 0.01 and0.42 + 0.02, 1038.11 + 1.46 and 1037.30 + 1.39(100ug/ml). By paired t test, two sets of data were statistically significant.By non parametric tests, the difference between twogroups, except for water content,the median of iodine content and standard iodine content in AFP response group was higher than that in AFP non response group.Conclusion:1.The energy spectrum CT can supply multi parameters for analysis on patients with primary liver cancer effect after TACE, and at the 40Kev-90 Kev level single energy CT value, iodine content and its standardization are most sensitive.2.Before and after the treatment, there are same trend between the single energy CT value, the iodine content, the iodine content standardization and clinical sensitivity index(AFP).3.The energy spectrum CT can provide a new evaluation method for the clinical micro effect in patients after TACE treatment.