曹 源,栗海龙

结直肠癌（CRC）是全球范围内常见的恶性肿瘤之一，肝脏是其最常见的转移部位。尽管手术切除、化疗和靶向治疗已经显著改善了结直肠癌肝转移患者的生存率，但如何有效评估化疗联合靶向治疗的疗效仍是临床治疗中的难题。近年来，能谱CT（Spectral CT）作为一种新型影像学技术，因其具有更高的成像分辨率和更精确的组织分辨能力，已在结直肠癌肝转移的评估中得到了广泛应用。本文旨在综述能谱CT在结直肠癌肝转移患者化疗联合靶向治疗疗效评估中的研究进展，探讨其优势、局限及未来的发展潜力和方向。

结直肠癌；肝转移；能谱CT；化疗；靶向治疗；疗效评估

[1] BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2024,74(3):229-263. [2] MARTIN J,PETRILLO A,SMYTH E C,et al.Colorectal liver metastases:Current management and future perspectives[J].World J Clin Oncol,2020,11(10):761-808. [3] AL BANDAR M H,KIM N K.Current status and future perspectives on treatment of liver metastasis in colorectal cancer(Review) [J].Oncol Rep,2017,37(5):2553-2564. [4] GARNETT R.A comprehensive review of dual-energy and multi-spectral computed tomography[J].Clin Imaging,2020,67:160-169. [5] ZIRAKCHIAN ZADEH M.PET/CT in assessment of colorectal liver metastases:a comprehensive review with emphasis on(18)F-FDG [J].Clin Exp Metastasis,2023,40(6):465-491. [6] LUO N,LI W,XIE J,et al.Preoperative normalized iodine concentration derived from spectral CT is correlated with early recurrence of hepatocellular carcinoma after curative resection[J].Eur Radiol,2021,31(4):1872-1882. [7] DEMIRLER SIMSIR B,DANSE E,COCHE E.Benefit of dual-layer spectral CT in emergency imaging of different organ systems[J]. Clin Radiol,2020,75(12):886-902. [8] BAE J S,YOON J H,KIM J H,et al.Evaluation of colorectal liver metastases using virtual monoenergetic images obtained from dual-layer spectral computed tomography[J].Abdom Radiol(NY),2024 [9] SO A,NICOLAOU S.Spectral Computed Tomography:Fundamental Principles and Recent Developments[J].Korean J Radiol,2021,22(1):86-96. [10] LI S,YUAN L,YUE M,et al.Early evaluation of liver metastasis using spectral CT to predict outcome in patients with colorectal cancer treated with FOLFOXIRI and bevacizumab[J].Cancer Imaging,2023,23(1):30. [11] KANG B,CHOI W S,KANG J H,et al.Spectral CT Imaging-Based Quantification of Iodized Oil Retention following Chemoembolization:Phantom and Animal Studies[J].J Vasc Interv Radiol,2020,31(3):503-509.e1. [12] HAN S,HUANG R,YAO F,et al.Pre-treatment spectral CT combined with CT perfusion can predict hemorrhagic transformation after thrombolysis in patients with acute ischemic stroke[J].Eur J Radiol,2022,156:110543.

点击下载PDF