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文献速递泌尿生殖介入CT

CT定量参数预测前列腺动脉栓塞术后临床成功

Quantitative CT biomarkers for predicting clinical outcomes after prostatic artery embolization: Results of the prospective pilot EMBOPERF study
RSS 订阅 · Diagnostic and Interventional Imaging · 2026-05-20

本前瞻性先导研究纳入38例症状性良性前列腺增生患者，在PAE术前行CT灌注及双能CT检查。结果显示静脉期-延迟期碘负荷比可独立预测3个月临床成功，AUC达0.931。

要点

  • 静脉期-延迟期碘负荷比高的患者PAE术后3个月临床成功率更高
  • 灌注整体增强值在成功组也显著高于失败组
  • 该定量参数有望用于PAE术前患者筛选与个体化管理

核心结论

  • CT衍生的静脉期-延迟期碘负荷比是预测BPH患者PAE术后临床成功的有前景的无创生物标志物
  • 该发现有助于改善患者筛选并个体化BPH管理

研究设计与样本

  • 前瞻性先导研究，纳入38例症状性BPH男性患者
  • 平均年龄74.1±9.2岁，平均前列腺体积107.7±45.1mL
  • PAE术前行CT灌注及双能CT检查，双能CT包括静脉期80秒及延迟期3分钟
  • 临床成功定义为3个月后拔除留置导尿管或IPSS降低至少25%和/或QoL改善至少1分

诊断标准与关键数值

  • 静脉期-延迟期碘负荷比预测临床成功的敏感度为81%，95%CI：62-93
  • 静脉期-延迟期碘负荷比预测临床成功的特异度为100%，95%CI：59-100
  • 静脉期-延迟期碘负荷比预测临床成功的AUC为0.931，95%CI：0.850-1.000
  • 成功组灌注整体增强值为0.117±0.175，失败组为0.051±0.020，P=0.018
  • 成功组静脉期-延迟期碘负荷比为0.886±0.138，失败组为0.650±0.096，P<0.001

临床应用与阅片要点

  • PAE术前双能CT延迟期与静脉期碘负荷比可作为预测术后临床成功的定量参考指标
  • 静脉期-延迟期碘负荷比在多变量分析中仍是PAE成功的独立预测因子，P=0.030

局限性

  • 先导研究，样本量仅38例
  • 单中心设计
英文原文（摘要）· 点击展开

PURPOSE: The purpose of this study was to prospectively evaluate whether quantitative variables obtained using computed tomography (CT) perfusion and dual-energy CT (DECT) can predict 3-month clinical success after prostatic artery embolization (PAE) in patients with benign prostatic hyperplasia (BPH).

MATERIALS AND METHODS: Thirty-eight men (mean age, 74.1 ± 9.2 [standard deviation (SD)] years; mean prostate volume, 107.7 ± 45.1 [SD] mL) with symptomatic BPH underwent CT perfusion and DECT (venous phase at 80 s; delayed phase at 3 min) before PAE. Quantitative variables included the perfusion integrated total enhancement (ITE), delayed-phase iodine charge, and venous-to-delayed iodine charge ratio. Clinical success was defined as the removal of an indwelling catheter or a reduction of at least 25 % in the International Prostate Symptom Score (IPSS) and/or an improvement of at least one point in quality of life (QoL) after three months. Statistical analyses included group comparisons, receiver-operating characteristic (ROC) analysis, and targeted multivariable logistic regression analysis.

RESULTS: Clinical success was achieved in 31/38 patients (82 %). Patients with successful PAE had a significantly greater ITE (0.117 ± 0.175 [SD]) and a higher venous-to-delayed iodine charge ratio (0.886 ± 0.138 [SD]) than those with failed PAE (0.051 ± 0.020 [SD], and 0.650 ± 0.096 [SD], respectively; P = 0.018 and P < 0.001, respectively. Venous-to-delayed iodine charge ratio yielded 81 % sensitivity (95 % confidence interval [CI]: 62-93), 100 % specificity (95 % CI: 59-100) and an area under the ROC curve (AUC) of 0.931 (95 % CI: 0.850-1.000) to predict clinical success of PAE. In multivariable analysis, the venous-to-delayed iodine charge ratio remained an independent predictor of PAE success (P = 0.030).

CONCLUSION: The CT-derived venous-to-delayed iodine charge ratio is a promising noninvasive biomarker for predicting clinical success after PAE in patients with BPH. These findings could improve patient selection and personalize BPH management.

来源：Diagnostic and Interventional Imaging，查看原文。版权归原作者所有。

引用

  1. Diagnostic and Interventional Imaging：Quantitative CT biomarkers for predicting clinical outcomes after prostatic artery embolization: Results of the prospective pilot EMBOPERF study
  2. Sammoud, Dabli, De Oliveira, et al. Quantitative CT biomarkers for predicting clinical outcomes after prostatic artery embolization: Results of the prospective pilot EMBOPERF study. Diagn Interv Imaging. 2026. PMID: 42161753. doi:10.1016/j.diii.2026.05.003
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供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。