BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with ...BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.展开更多
Grating-based X-ray phase-contrast imaging enhances the contrast of imaged objects,particularly soft tissues.However,the radiation dose in computed tomography(CT)is generally excessive owing to the complex collection ...Grating-based X-ray phase-contrast imaging enhances the contrast of imaged objects,particularly soft tissues.However,the radiation dose in computed tomography(CT)is generally excessive owing to the complex collection scheme.Sparse-view CT collection reduces the radiation dose,but with reduced resolution and reconstructed artifacts particularly in analytical reconstruction methods.Recently,deep learning has been employed in sparse-view CT reconstruction and achieved stateof-the-art results.Nevertheless,its low generalization performance and requirement for abundant training datasets have hindered the practical application of deep learning in phase-contrast CT.In this study,a CT model was used to generate a substantial number of simulated training datasets,thereby circumventing the need for experimental datasets.By training a network with simulated training datasets,the proposed method achieves high generalization performance in attenuationbased CT and phase-contrast CT,despite the lack of sufficient experimental datasets.In experiments utilizing only half of the CT data,our proposed method obtained an image quality comparable to that of the filtered back-projection algorithm with full-view projection.The proposed method simultaneously addresses two challenges in phase-contrast three-dimensional imaging,namely the lack of experimental datasets and the high exposure dose,through model-driven deep learning.This method significantly accelerates the practical application of phase-contrast CT.展开更多
目的对脑梗死伴大脑中动脉狭窄患者进行CT血管成像(computed tomography angiography,CTA)联合CT灌注成像(computed tomography perfusion imaging,CTP)检查,拟从侧支循环及脑血管储备能力方面探讨头穴透刺对脑梗死伴大脑中动脉狭窄患...目的对脑梗死伴大脑中动脉狭窄患者进行CT血管成像(computed tomography angiography,CTA)联合CT灌注成像(computed tomography perfusion imaging,CTP)检查,拟从侧支循环及脑血管储备能力方面探讨头穴透刺对脑梗死伴大脑中动脉狭窄患者的治疗效果。方法收集该院神经内科在2022年1月—2023年12月住院治疗的80例脑梗死伴大脑中动脉狭窄患者纳入研究,通过随机数字表法分为观察组与对照组,各40例。对照组给予西医常规基础用药,观察组在对照组治疗基础上给予头穴透刺干预,每次治疗30 min,每周连续治疗5 d,暂停2 d,共治疗4周。CTP测量并获得局部脑血流量(regional cerebral blood flow,rCBF)、局部脑血容量(regional cerebral blood volume,rCBV)、局部达峰时间(regional time to peak,rTTP)及局部平均通过时间(regional mean transittime,rMTT)相对灌注值;CTA观察并进行侧支循环评分,以判断侧支循环情况。治疗前后所有患者行头颅多普勒超声检查,获得双侧大脑中动脉的血流平均速度(mean velocity,Vm)及搏动指数(pulsatility index,PI),计算脑血管储备功能(cerebrovascular reserve,CVR)水平。比较两组患者治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、改良Barthel指数(modified Barthel index,MBI)评分、脑卒中专用生活质量量表(stroke-specific quality of life scale,SS-QOL)评分;测定并比较治疗前后血清神经功能指标水平,包含神经元特异性烯醇化酶(neuron specific enolase,NSE)、神经纤维丝轻链(neurofilament light chain,NFL)及脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)。结果两组患者CTP参数比较,治疗后rCBF、rCBV显著高于治疗前(P<0.05),rTTP、rMTT显著低于治疗前(P<0.05);治疗后观察组rCBF、rCBV显著高于对照组(P<0.05),rTTP、rMTT显著低于对照组(P<0.05)。两组患者侧支循环情况比较,治疗后侧支循环评分均显著高于治疗前(P<0.05),观察组显著高于对照组(P<0.05);治疗后观察组侧支循环不良比例(3/40)显著低于对照组(10/40)(χ^(2)=4.501,P<0.05)。两组患者脑血管储备能力比较,治疗后Vm、CVR水平显著高于治疗前(P<0.05),PI显著低于治疗前(P<0.05);治疗后观察组Vm、CVR水平显著高于对照组(P<0.05),PI显著低于对照组(P<0.05)。两组患者治疗后MBI评分、SS-QOL评分及BDNF水平显著高于治疗前(P<0.05),NIHSS评分及NSE、NFL水平显著低于治疗前(P<0.05);治疗后观察组MBI评分、SS-QOL评分及BDNF水平显著高于对照组(P<0.05),NIHSS评分及NSE、NFL水平显著低于对照组(P<0.05)。结论头穴透刺治疗脑梗死伴大脑中动脉狭窄患者,能显著改善患者神经功能缺损情况,提高患者的日常生活能力及生活质量,CTA联合CTP评估提示头穴透刺能够明显改善脑梗死伴大脑中动脉狭窄患者侧支循环及脑血管储备能力。展开更多
文摘BACKGROUND Photon-counting detector(PCD)CT represents a transformative advancement in radiological imaging,offering superior spatial resolution,enhanced contrast-tonoise ratio,and reduced radiation dose compared with the conventional energyintegrating detector CT.AIM To evaluate PCD CT in oncologic imaging,focusing on its role in tumor detection,staging,and treatment response assessment.METHODS We performed a systematic PubMed search from January 1,2017 to December 31,2024,using the keywords“photon-counting CT”,“cancer”,and“tumor”to identify studies on its use in oncologic imaging.We included experimental studies on humans or human phantoms and excluded reviews,commentaries,editorials,non-English,animal,and non-experimental studies.Study selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Out of 175 initial studies,39 met the inclusion criteria after screening and full-text review.Data extraction focused on study type,country of origin,and oncologic applications of photon-counting CT.No formal risk of bias assessment was performed,and the review was not registered in PROSPERO as it did not include a meta-analysis.RESULTS Key findings highlighted the advantages of PCD CT in imaging renal masses,adrenal adenomas,ovarian cancer,breast cancer,prostate cancer,pancreatic tumors,hepatocellular carcinoma,metastases,multiple myeloma,and lung cancer.Additionally,PCD CT has demonstrated improved lesion characterization and enhanced diagnostic accuracy in oncology.Despite its promising capabilities challenges related to data processing,storage,and accessibility remain.CONCLUSION As PCD CT technology evolves,its integration into routine oncologic imaging has the potential to significantly enhance cancer diagnosis and patient management.
基金supported by the National Natural Science Foundation of China(Nos.U2032148,U2032157,11775224)USTC Research Funds of the Double First-Class Initiative(No.YD2310002008)the National Key Research and Development Program of China(No.2017YFA0402904),the Youth Innovation Promotion Association,CAS(No.2020457)。
文摘Grating-based X-ray phase-contrast imaging enhances the contrast of imaged objects,particularly soft tissues.However,the radiation dose in computed tomography(CT)is generally excessive owing to the complex collection scheme.Sparse-view CT collection reduces the radiation dose,but with reduced resolution and reconstructed artifacts particularly in analytical reconstruction methods.Recently,deep learning has been employed in sparse-view CT reconstruction and achieved stateof-the-art results.Nevertheless,its low generalization performance and requirement for abundant training datasets have hindered the practical application of deep learning in phase-contrast CT.In this study,a CT model was used to generate a substantial number of simulated training datasets,thereby circumventing the need for experimental datasets.By training a network with simulated training datasets,the proposed method achieves high generalization performance in attenuationbased CT and phase-contrast CT,despite the lack of sufficient experimental datasets.In experiments utilizing only half of the CT data,our proposed method obtained an image quality comparable to that of the filtered back-projection algorithm with full-view projection.The proposed method simultaneously addresses two challenges in phase-contrast three-dimensional imaging,namely the lack of experimental datasets and the high exposure dose,through model-driven deep learning.This method significantly accelerates the practical application of phase-contrast CT.
文摘目的对脑梗死伴大脑中动脉狭窄患者进行CT血管成像(computed tomography angiography,CTA)联合CT灌注成像(computed tomography perfusion imaging,CTP)检查,拟从侧支循环及脑血管储备能力方面探讨头穴透刺对脑梗死伴大脑中动脉狭窄患者的治疗效果。方法收集该院神经内科在2022年1月—2023年12月住院治疗的80例脑梗死伴大脑中动脉狭窄患者纳入研究,通过随机数字表法分为观察组与对照组,各40例。对照组给予西医常规基础用药,观察组在对照组治疗基础上给予头穴透刺干预,每次治疗30 min,每周连续治疗5 d,暂停2 d,共治疗4周。CTP测量并获得局部脑血流量(regional cerebral blood flow,rCBF)、局部脑血容量(regional cerebral blood volume,rCBV)、局部达峰时间(regional time to peak,rTTP)及局部平均通过时间(regional mean transittime,rMTT)相对灌注值;CTA观察并进行侧支循环评分,以判断侧支循环情况。治疗前后所有患者行头颅多普勒超声检查,获得双侧大脑中动脉的血流平均速度(mean velocity,Vm)及搏动指数(pulsatility index,PI),计算脑血管储备功能(cerebrovascular reserve,CVR)水平。比较两组患者治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、改良Barthel指数(modified Barthel index,MBI)评分、脑卒中专用生活质量量表(stroke-specific quality of life scale,SS-QOL)评分;测定并比较治疗前后血清神经功能指标水平,包含神经元特异性烯醇化酶(neuron specific enolase,NSE)、神经纤维丝轻链(neurofilament light chain,NFL)及脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)。结果两组患者CTP参数比较,治疗后rCBF、rCBV显著高于治疗前(P<0.05),rTTP、rMTT显著低于治疗前(P<0.05);治疗后观察组rCBF、rCBV显著高于对照组(P<0.05),rTTP、rMTT显著低于对照组(P<0.05)。两组患者侧支循环情况比较,治疗后侧支循环评分均显著高于治疗前(P<0.05),观察组显著高于对照组(P<0.05);治疗后观察组侧支循环不良比例(3/40)显著低于对照组(10/40)(χ^(2)=4.501,P<0.05)。两组患者脑血管储备能力比较,治疗后Vm、CVR水平显著高于治疗前(P<0.05),PI显著低于治疗前(P<0.05);治疗后观察组Vm、CVR水平显著高于对照组(P<0.05),PI显著低于对照组(P<0.05)。两组患者治疗后MBI评分、SS-QOL评分及BDNF水平显著高于治疗前(P<0.05),NIHSS评分及NSE、NFL水平显著低于治疗前(P<0.05);治疗后观察组MBI评分、SS-QOL评分及BDNF水平显著高于对照组(P<0.05),NIHSS评分及NSE、NFL水平显著低于对照组(P<0.05)。结论头穴透刺治疗脑梗死伴大脑中动脉狭窄患者,能显著改善患者神经功能缺损情况,提高患者的日常生活能力及生活质量,CTA联合CTP评估提示头穴透刺能够明显改善脑梗死伴大脑中动脉狭窄患者侧支循环及脑血管储备能力。
