Chen Anliang, Presenter: Nothing to Disclose

Ailian Liu MD, Abstract Co-Author: Nothing to Disclose

Jinghong Liu, Abstract Co-Author: Nothing to Disclose

Shifeng Tian, Abstract Co-Author: Nothing to Disclose

He Qing Wang MSc, Abstract Co-Author: Nothing to Disclose

Ye Ju, Abstract Co-Author: Nothing to Disclose

Yijun Liu, Abstract Co-Author: Nothing to Disclose

Renwang Pu MBBCh, FRCPC, Abstract Co-Author: Nothing to Disclose

To explore the application value of gemstone spectral imaging (GSI) in the differential diagnosis of bladder cancer and prostate hyperplasia.

This study was approved by the Ethics Committee in our hospital and all patients provided the informed consent. A retrospective analysis was performed in 118 male patients who received pelvic GSI in our hospital from July 2011 to February 2013. Polychromatic CT value and 40~140keV (interval: 10keV) monochromatic CT values were measured in both groups, and then get GSI curves, the effective atomic number and its distribution peak value. The results were analyzed with independent sample t-test. The ROC curve was generated using the monochromatic energy level (keV) at which the biggest difference in CT value was observed between two groups, then the area under curve (AUC) was calculated, and analyzed the diagnostic performance of AUC.

There was a statistically significant difference in CT value between bladder cancer and prostrate hyperplasia group at 40~90keV, which was biggest at 40keV ((84.67±21.38)HU vs. (62.86±13.99)HU). The AUC, maximum Youden index and diagnostic threshold of CT value were 0.817, 0.595 and 73.365HU, and the sensitivity and specificity were 77% and 82.5% (40keV). The slope of bladder cancer GSI curve was markedly greater than that of prostrate hyperplasia (k=-0.51 vs. -0.30); the differences in effective atomic number((8.00±0.20) vs. (7.82±0.14)) and peak value((8.00±0.21) vs. (7.83±0.17)) were significant statistically.

The bladder cancer and prostate hyperplasia had different characteristic on spectral CT imaging. Low keV energy image of CT values play an important role in the identification, and the larger spectral curve slope point out the lesions from the bladder. Effective atomic number and its peak value in the differential also has a certain role. And spectral CT imaging with multiple parameters can distinguish these two types of disease with a higher accuracy compared to the hybrid energy CT imaging.

HDCT-GSI post-processing data have a good clinical application in the differential diagnosis of posterior wall bladder cancer and prostrate hyperplasia with intravesical protrusion.

Anliang, C, Liu, A, Liu, J, Tian, S, Wang, H, Ju, Y, Liu, Y, Pu, R, Application of Gemstone Spectral Imaging in Differential Diagnosis of Bladder Cancer and Prostate Hyperplasia.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007194.html