The Application Of Quantitative Parameters Of Spectral CT In The Evaluation Of Biological Behaviour Of Peripheral Lung Cancer

Objective To explore the application value of quantitative parameters of spectral CT in the evaluation of biological behavior of peripheral lung cancer in order to provide a valuable reference for the clinical treatment and prognosis evaluation of peripheral lung cancer.Methods From January 2015 to October 2017,74 patients with lung placeholder were detected by spectral CT dual phase enhancement scan,49 of whom were confirmed to be peripheral lung cancer after surgical resection and met the inclusion criteria.The normalized iodine concentrations,the normalized water concentrations,the CT values at 40 keV,the slope of the spectral curve were measured.The expression of VEGF,EGFR,MVD,Ki-67 were detected by immunohistochemical staining in the tumour tissue.The correlation between VEGF,EGFR,MVD,Ki-67 expression and spectral CT imaging was estimated through Spearman's rank correlation analysis.P<0.05,there is a correlation.Results 1.The normalized iodine concentrations of the 49 cases were(0.21±0.06),which were positively correlated with the total score of VEGF and MVD expression(r=0,314,P =0.028),(r=0.400,P=0.004).There were no correlation with EGFR expression total score and Ki-67 positive cell percentage(P > 0.05).The normalized water concentrations were(0.99±0.02),which showed a negative correlation with MVD(r=-0.292,P=0.042),and displayed no correlation with VEGF expression total score,EGFR expression total score,and Ki-67 positive cell percentage(P>0.05).The CT values at 40 keV was(191.08±55.42)HU,which displayed positive correlation with total score of VEGF(r=0.339,P=0.017),and with the MVD values(r=0.323,P =0.024),and showed no correlation with EGFR expression total score and Ki-67 positive cell percentage(P>0.05).The slope of the spectral attenuation curves(-2.57±1.35),which showed positive correlation with total score of VEGF(r=-0.398,P =0.005),and with the MVD values(r=-0.391,P =0.006),and had no correlation with EGFR expression total score and ki-67 positive cell percentage(P>0.05).2.There were significant differences in normalized iodine concentrations,normalized water concentrations,CT value at 40 keV and slope of spectral attenuation curves between groups with different grades of VEGF expression(P < 0.05),but there was no difference in standardized water content among different grades of VEGF(P>0.05).There were no significant difference in the quantitative parameters of each energy spectrum CT between the different expression levels of EGFR and Ki-67(P>0.05).3.The normalized iodine concentrations of adenocarcinoma group and squamous cell carcinoma group respectively were(0.24±0.07)?(0.18±0.04),respectively.The normalized iodine concentrations of adenocarcinoma were higher than that of squamous cell carcinoma(P<0.05).There were no significant difference in the normalized water concentrations,the CT value of 40 keV and the slope of spectral attenuation curves between the two groups(P>0.05).Conclusion The correlation between the quantitative parameters of peripheral lung cancer energy spectrum CT and biological behavior related factor VEGF,MVD,which could indirectly reflect the blood supply of lung cancer and evaluate the biological behavior of lung cancer before operation.The quantitative parameters of Spectral CT can provide objective basis for pathological classification of peripheral lung cancer.