The Value Of Gemstone CT Spectral Imaging On Evaluation On Effect Of FOLFOX Scheme Chemotherapy Curative Of Hepatic Metastases Of Gastrointestinal Tumors

Objective:Through analying the data of before and after FOLFOX scheme chemotherapy curative of hepatic metastases of gastrointestinal tumors, to evaluate the value of Gemstone CT Spectral Imaging on effect of chemotherapy of hepatic metastases.Materials and methods:Collecting thirty patients within our hospital between October2012and December2013, the patients who have primary lesion of gastrointestinal tumor which cleared by pathologic results and the patients with liver metastases (untreated) which confirmed by imaging examination need to do the FOLFOX scheme chemotherapy curative which were filled with four courses.Before and after chemotherapy, all the patients do the enhancement scanning and image reconstruction by the GSI. In the venous phase,we can obtain the CT values under different Kev energy spectrum image on different positions of the hepatic metastatic lesions and abdominal aorta,which is to calculate the CT value ratio between the lesions and abdominal aorta (standard CT value); Through the corresponding spectral curve,we can calculate the spectral curve of the slope. In this test, we take40Kev and100Kev two points as a reference point, the following is the calculation method of the slope of the spectral curve.Slope-(HU40Kev-HU100Kev)/60. And as the base material of iodine and water base figure obtained corresponding iodine content and water content,to calculate the standard iodine content/water content value.And the data received of the hepatic metastases before and after the treatment were analyed by the paired t test statisitical methods.Results:the groups of different part of hepatic metastatic lesions before and after treatment under different Kev standard CT value, energy spectrum curve slope,standard iodine content and standard water content in the normality test accord with normal distribution, within the group to choose matching t test.(1) Standard CT value analysis under different Kev:edge of hepatic metastatic lesion group, before and after chemotherapy in the40-120Kev standard CT value were statistically difference (P<0.05), the standard CT value under the120-140Kev have no statistical difference (P>0.05); center of hepatic metastatic lesion group, before and after chemotherapy in the40-110kev standard CT value was statistically difference (P<0.05), in110-140kev standard CT value have no statistical difference (P>0.05).(2) The standard iodine content analysis:the edge of hepatic metastatic lesion group and the center of hepatic metastatic lesion group, and the standard iodine content before and after chemotherapy were statistically difference (P<0.05).(3) The standard water content value analysis:the edge of hepatic metastatic lesion group and the center of hepatic metastatic lesion group, and the standard iodine content before and after chemotherapy have no statistical difference (P>0.05).(4) Energy spectrum curve slope analysis:Results found that groups of different position of hepatic metastatic before and after chemotherapy of line spectrum curve trend is roughly same, to gradually decline curve, as the increase of Kev, curve gradually tend to be flat, this research takes40Kev and100Kev two points as a reference point,40-100Kev energy spectrum curve slope of the edge of lesion group and the center of lesion group before and after chemotherapy were statistically difference (P<0.05).Conclusion:GSI has important clinical follow-up observation value in patients with hepatic metastases of gastrointestinal tumors under FOLFOX scheme chemotherapy curative, through analyzing the standard iodine content value,the standard CT value under lower energy and energy spectrum curve slope of the edge and center of the hepatic metastases before and after chemotherapy,these can reflect:(1) Hepatic metastatic lesions after four courses of chemotherapy did not melt completely, which still have residual, it can provide a direction for following treatment;(2) The standard CT values and the standard iodine content values of the edge of the lesions were higher than that of the center of the lesions,which explains that the edge of the lesions have obviously more new blood vessels than that of the center of the lesion;(3)Through quantitatively analyzing the data between different groups before and after chemotherapy by GSI, we can primarily evaluate the value of effect of chemotherapy of FOLFOX scheme hepatic metastases,which can provide the certain reference value for clinical to evaluate the effect of treatment.