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Lu Y, Wu L, Yue X, Peng T, Yang M, Chen J, Han P. Quantitative Evaluation of Acute Pancreatitis Based on Dual-Energy Computed Tomography. J Comput Assist Tomogr 2025:00004728-990000000-00460. [PMID: 40423618 DOI: 10.1097/rct.0000000000001768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2024] [Accepted: 04/21/2025] [Indexed: 05/28/2025]
Abstract
OBJECTIVE To evaluate the value of dual-energy computed tomography (DECT) parameters for the quantitative diagnosis of acute pancreatitis (AP) and classification of its severity. METHODS Patients with AP underwent a plain CT scan and three contrast-enhanced DECT scans. We analyzed the group differences in iodine concentration (IC) and slope of the spectral Hounsfield unit curve (λHU) of the 3-phase enhanced scans (arterial, venous, and delayed phases). RESULTS The study included 60 AP patients (38 males and 22 females; mean age: 47.43±13.47 y). On the basis of the CT severity index (CTSI), the patients were divided into 2 groups: group A (mild AP, n=26) and group B (moderate/severe AP, n=34). IC and λHU in the arterial and venous phases were all significantly higher in group A than in group B (P<0.001) and could effectively differentiate the 2 groups. The areas under the curve were 0.753 (95% CI: 0.624-0.855), 0.799 (95% CI: 0.676-0.892), 0.774 (95% CI: 0.647-0.872), and 0.842 (95% CI: 0.724-0.923) for IC at arterial and venous phases and λHU at arterial and venous phases, respectively. These parameters decreased with the increase of CTSI, showing significant negative correlations, with r were -0.512 (95% CI: -0.678 to -0.297), -0.492 (95% CI: -0.663 to -0.272), -0.552 (95% CI: -0.707 to -0.346), -0.569 (95% CI: -0.719 to -0.368) for IC at arterial and venous phases and λHU at arterial and venous phases, respectively (P<0.001). CONCLUSIONS DECT imaging can quantitatively analyze AP, and the IC and λHU can be used to distinguish mild and severe cases, adding functional information to the CT morphology to determine the severity and prognosis of the disease.
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Affiliation(s)
- Yuting Lu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hubei Province Key Laboratory of Molecular Imaging
| | - Linxia Wu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hubei Province Key Laboratory of Molecular Imaging
| | - Xiaofei Yue
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hubei Province Key Laboratory of Molecular Imaging
| | - Tao Peng
- Departments of Pancreatic Surgery
| | - Ming Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hubei Province Key Laboratory of Molecular Imaging
| | - Jinhuang Chen
- Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ping Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology
- Hubei Province Key Laboratory of Molecular Imaging
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Geng D, Zhu LN, Liu J, Zhao XC, Wang YS, Xu XQ, Wu FY. Time-dependent diffusion magnetic resonance imaging for the analysis of parotid gland tumors. Acta Radiol 2025; 66:505-511. [PMID: 39835432 DOI: 10.1177/02841851241313108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2025]
Abstract
BackgroundDifferent parotid tumors differ in terms of treatment strategies due to their distinct biological behaviors. Time-dependent diffusion magnetic resonance imaging (td-dMRI) can characterize and quantify the cytological indexes, and then aid the differential diagnosis of various tumors. However, the value of td-dMRI in the analysis of parotid gland tumors remains unclear.PurposeTo investigate the value of quantitative parameters derived from td-dMRI in the analysis of parotid gland tumors.Material and MethodsIn total, 39 patients with parotid gland tumors were prospectively enrolled, including 24 patients with polymorphic adenomas (PAs), eight with Warthin's tumors (WTs), and seven with malignant tumors (MTs). Td-dMRI was performed for preoperative evaluation. Intracellular volume fraction (Vin), mean cell size (d), extracellular diffusion coefficient (Dex), and cellularity were obtained based on the Imaging Microstructural Parameters Using Limited Spectrally Edited Diffusion model, and compared among the three groups. One-way ANOVA, Kruskal-Wallis test, and receiver operating characteristic (ROC) curve analysis were performed for further statistical analysis as appropriate.ResultsSignificant differences were found in all td-dMRI-derived indexes among PAs, WTs, and MTs (all P < 0.05). Vin was the sole parameter with significant differences for all sub-group comparisons (PAs vs. WTs, P < 0.001; PAs vs. MTs, P = 0.031; WTs vs. MTs, P = 0.047). With Vin values of 0.267, 0.231, and 0.260 as threshold, respectively, optimal performance levels were obtained for differentiating PAs from WTs (area under the ROC curve [AUC]=0.932, sensitivity=0.917, and specificity=0.875), PAs from MTs (AUC=0.744, sensitivity=0.833, and specificity=0.714), and WTs from MTs (AUC=0.750, sensitivity=0.875, and specificity=0.714).ConclusionMicrostructural parameters derived from td-dMRI, especially Vin, might be promising imaging biomarkers for characterizing parotid gland tumors.
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Affiliation(s)
- Di Geng
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, PR China
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Liu-Ning Zhu
- Department of Stomatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Jun Liu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | | | - Yi-Shi Wang
- MR Collaboration, Siemens Healthineers Ltd, Beijing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Chen W, Lin G, Li X, Feng Y, Mao W, Kong C, Hu Y, Gao Y, Yang W, Chen M, Yan Z, Xia S, Lu C, Xu M, Ji J. Dual-energy computed tomography for predicting histological grading and survival in patients with pancreatic ductal adenocarcinoma. Eur Radiol 2025; 35:2818-2832. [PMID: 39414655 DOI: 10.1007/s00330-024-11109-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 08/07/2024] [Accepted: 09/24/2024] [Indexed: 10/18/2024]
Abstract
OBJECTIVES We evaluated the value of dual-energy computed tomography (DECT) parameters derived from pancreatic ductal adenocarcinoma (PDAC) to discriminate between high- and low-grade tumors and predict overall survival (OS) in patients. METHODS Data were retrospectively collected from 169 consecutive patients with pathologically confirmed PDAC who underwent third-generation dual-source DECT enhanced dual-phase scanning before surgery between January 2017 and March 2023. Patients with prior treatments, other malignancies, small tumors, or poor-quality scans were excluded. Two radiologists evaluated three clinical and seven radiological features and measured sixteen DECT-derived parameters. Univariate and multivariate analyses were applied to select independent predictors. A prediction model and a corresponding nomogram were developed, and the area under the curve (AUC), calibration, and clinical applicability were assessed. The correlations between factors and OS were evaluated using Kaplan-Meier survival and Cox regression analyses. RESULTS One hundred sixty-nine patients were randomly divided into training (n = 118) and validation (n = 51) cohorts, among which 43 (36.4%) and 19 (37.3%) had high-grade PDAC confirmed by pathology, respectively. The vascular invasion, normalized iodine concentration in the venous phase, and effective atomic number in the venous phase were independent predictors for histological grading. A nomogram was constructed to predict the risk of high-grade tumors in PDAC, with AUCs of 0.887 and 0.844 in the training and validation cohorts, respectively. The nomogram exhibited good calibration and was more beneficial than a single parameter in both cohorts. Pathological- and nomoscore-predicted high-grade PDACs were associated with poor OS (all p < 0.05). CONCLUSIONS The nomogram, which combines DECT parameters and radiological features, can predict the histological grade and OS in patients with PDAC before surgery. KEY POINTS Question Preoperative determination of histological grade in PDAC is crucial for guiding treatment, yet current methods are invasive and limited. Findings A DECT-based nomogram combining vascular invasion, normalized iodine concentration, and effective atomic number accurately predicts histological grade and OS in PDAC patients. Clinical relevance The DECT-based nomogram is a reliable, non-invasive tool for predicting histological grade and OS in PDAC. It provides essential information to guide personalized treatment strategies, potentially improving patient management and outcomes.
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Affiliation(s)
- Weiyue Chen
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Guihan Lin
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Xia Li
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Ye Feng
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Weibo Mao
- Department of Pathology, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
| | - Chunli Kong
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Yumin Hu
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Yang Gao
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Weibin Yang
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Minjiang Chen
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Zhihan Yan
- Wenzhou Key Laboratory of Structural and Functional Imaging, Wenzhou, China
| | - Shuiwei Xia
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Chenying Lu
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Min Xu
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China
| | - Jiansong Ji
- Zhejiang Key Laboratory of Imaging and Interventional Medicine, Zhejiang Engineering Research Center of Interventional Medicine Engineering and Biotechnology, Key Laboratory of Precision Medicine of Lishui City, The Fifth Affiliated Hospital of Wenzhou Medical University, Lishui, China.
- Clinical College of The Affiliated Central Hospital, School of Medicine, Lishui University, Lishui, China.
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Lai YF, Liang ZM, Li JF, Zhang JY, Xu DH, Dai HY. Spectral computed tomography parameters of primary tumors and lymph nodes for predicting tumor deposits in colorectal cancer. World J Radiol 2025; 17:103359. [PMID: 40309472 PMCID: PMC12038403 DOI: 10.4329/wjr.v17.i4.103359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2024] [Revised: 03/17/2025] [Accepted: 03/26/2025] [Indexed: 04/22/2025] Open
Abstract
BACKGROUND Tumor deposits (TDs) are an independent predictor of poor prognosis in colorectal cancer (CRC) patients. Enhanced follow-up and treatment monitoring for TD+ patients may improve survival rates and quality of life. However, the detection of TDs relies primarily on postoperative pathological examination, which may have a low detection rate due to sampling limitations. AIM To evaluate the spectral computed tomography (CT) parameters of primary tumors and the largest regional lymph nodes (LNs), to determine their value in predicting TDs in CRC. METHODS A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available. Patients were divided into the TDs+ group and the TDs- group on the basis of their pathological results. Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured, including the normalized iodine concentration (NIC) in both the arterial and venous phases, and the LN-to-primary tumor ratio was calculated. Statistical methods were used to evaluate the diagnostic efficacy of each spectral parameter. RESULTS Among the 121 CRC patients, 33 (27.2%) were confirmed to be TDs+. The risk of TDs positivity was greater in patients with positive LN metastasis, higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels. The NIC (LNs in both the arterial and venous phases), NIC (primary tumors in the venous phase), and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs (P < 0.05). In multivariate logistic regression analysis, the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs, demonstrating the highest diagnostic performance (area under the curve: 0.812, sensitivity: 0.879, specificity: 0.648, cutoff value: 1.145). CONCLUSION The spectral CT parameters of the primary colorectal tumor and the largest regional LNs, especially the LN-to-primary tumor ratio, have significant clinical value in predicting TDs in CRC.
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Affiliation(s)
- Yi-Fan Lai
- The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
- Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
| | - Zhao-Ming Liang
- The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
- Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
| | - Jing-Fang Li
- Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
| | - Jia-Ying Zhang
- The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
- Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
| | - Ding-Hua Xu
- The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
- Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
| | - Hai-Yang Dai
- The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
- Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
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Liu X, Chen XL, Yuan Y, Pu H, Li H. Dual-energy CT quantitative parameters for prediction of prognosis in patients with resectable rectal cancer. Eur Radiol 2025:10.1007/s00330-025-11398-3. [PMID: 39921716 DOI: 10.1007/s00330-025-11398-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 12/03/2024] [Accepted: 01/05/2025] [Indexed: 02/10/2025]
Abstract
OBJECTIVE To determine whether quantitative parameters derived from dual-energy CT (DECT) could predict prognosis in patients with resectable rectal cancer (RC). MATERIALS AND METHODS One hundred and thirty-four patients (recurrence/distant metastasis group, n = 36; non-metastasis/non-recurrence group, n = 98) with RC who underwent radical resection and DECT were retrospectively included. DECT quantitative parameters, including iodine concentration (IC), normalized iodine concentration (NIC), electron density (Rho), effective atomic number (Zeff), dual-energy index (DEI), the slope of the spectral Hounsfield unit curve (λHU) on arterial and venous phase images. Univariate and multivariate Cox proportional hazards models were employed to identify independent risk factors of prognosis. The area under the receiver operating characteristic curve (AUC) was used to assess the performance. Disease-free survival (DFS) curves were constructed using the Kaplan-Meier method. RESULTS Patients in the metastasis/recurrence group had higher Rho in arterial phase (A-Rho), NIC in venous phase (V-NIC), Rho in venous phase (V-Rho), Zeff in venous phase (V-Zeff), λHU in venous phase (V-λHU), pT stage, pN stage, serum carcinoembryonic antigen (CEA), carbohydrate antigen-199 levels and more frequent in extramural venous invasion than those in non-metastasis/non-recurrence group (all p < 0.05). V-NIC, V-λHU, and CEA were independent risk factors of recurrence/distant metastasis (all p < 0.05). The AUC of combined indicator integrating three independent risk factors achieved the best diagnostic performance (AUC = 0.900). In stratified survival analysis, patients with high V-NIC, V-λHU, and CEA had lower 3-year DFS than those with low V-NIC, V-λHU, and CEA. CONCLUSION Combining V-NIC, V-λHU, and CEA could be used to noninvasively predict prognosis in resectable RC. KEY POINTS Question TNM staging fails to accurately prognosticate; can quantitative parameters derived from dual-energy CT predict prognosis in patients with resectable rectal cancer? Findings Normalized iodine concentration (V-NIC) and the slope of the spectral Hounsfield unit curve in venous phase (V-λHU), and carcinoembryonic antigen (CEA) are independent risk factors for recurrence/metastasis. Clinical relevance The combined indicator integrating V-NIC, V-λHU, and CEA could predict 3-year disease-free survival in patients with resectable rectal cancer and could aid in postoperative survival risk stratification to guide personalized treatment.
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Affiliation(s)
- Xia Liu
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiao-Li Chen
- Department of Radiology, Affiliated Cancer Hospital of Medical School, University of Electronic Science and Technology of China, Sichuan Cancer Hospital, Chengdu, China
| | - Yi Yuan
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hong Pu
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Hang Li
- Department of Radiology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
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Shao C, He C, Zheng P, Zhou P, Chen X. Preoperative prediction of tumor budding and lymphovascular invasion in colon cancer using dual-energy CT: a prospective study with internal model validation. Abdom Radiol (NY) 2025:10.1007/s00261-025-04803-4. [PMID: 39825008 DOI: 10.1007/s00261-025-04803-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Revised: 01/04/2025] [Accepted: 01/07/2025] [Indexed: 01/20/2025]
Abstract
OBJECTIVE This study evaluates the potential of dual-energy CT (DECT) for preoperative prediction of tumor budding (TB) and lymphovascular invasion (LVI) in colon cancer. METHODS This prospective study enrolled 153 patients (mean age 61.33 years ± 0.88) with pathologically confirmed colon cancer. All participants underwent arterial and venous phase DECT scans within one week before surgery. Two radiologists independently analyzed the images, assessing tumor location, clinical N stage (cN stage), iodine concentration (IC), effective atomic number (Z-eff), and dual-energy index (DEI). The normalized iodine concentration (nIC) was obtained by comparing measured IC to the abdominal aortic IC. Logistic regression identified independent risk factors for high-grade TB and LVI positivity. The Akaike Information Criterion guided model selection, and the area under the curve (AUC) was calculated. Bootstrap validation with 1000 iterations was used for internal validation. RESULTS Tumor location and cN stage were identified as independent risk factors for high-grade TB, and nICA tumor and cN stage for LVI positivity. The optimal model for predicting high-grade TB included tumor location, cN stage, and DEIV tumor, with an AUC of 0.763 (sensitivity: 75.0%; specificity: 64.7%) and a mean AUC of 0.712. Similarly, the model for LVI positivity included nICA tumor, cN stage, and nICA peripheral fat, with an AUC of 0.811 (sensitivity: 71.7%; specificity: 76.6%) and a mean AUC of 0.814. CONCLUSION DECT could consistently quantify colon cancer characteristics, and DECT-based models performed well in the preoperative prediction of TB and LVI.
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Affiliation(s)
- Chuanyang Shao
- Department of Radiology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China
| | - Changjiu He
- Department of Radiology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China
| | - Ping Zheng
- Department of Pathology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China
| | - Peng Zhou
- Department of Radiology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China
| | - Xiaoli Chen
- Department of Radiology, Radiation Oncology Key Laboratory of Sichuan Province, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute,. Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, 610000, Chengdu, China.
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Chen J, Ni L, Gong J, Wu J, Qian T, Wang M, Huang J, Liu K. Quantitative parameters of dual-layer spectral detector computed tomography for evaluating differentiation grade and lymphovascular and perineural invasion in colorectal adenocarcinoma. Eur J Radiol 2024; 178:111594. [PMID: 38986232 DOI: 10.1016/j.ejrad.2024.111594] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 06/20/2024] [Accepted: 06/28/2024] [Indexed: 07/12/2024]
Abstract
PURPOSE To explore the predictive value of dual-layer spectral detector CT (SDCT) quantitative parameters for determining differentiation grade, lymphovascular invasion (LVI) and perineural invasion (PNI) in colorectal adenocarcinoma (CRAC) patients. METHODS A total of 106 eligible patients with CRAC were included in this study. Spectral parameters, including CT values at 40 and 100 keV, the effective atomic number (Zeff), the iodine concentration (IC), the slope of the spectral Hounsfield unit (HU) curve (λHU), and the normalized iodine concentration (NIC) in the arterial phase (AP) and venous phase (VP), were compared according to the differentiation grade and the status of LVI and PNI. The diagnostic accuracies of the quantitative parameters with statistical significance were determined via receiver operating characteristic (ROC) curves, and the area under the curve (AUC) was calculated. RESULTS There were 57 males and 49 females aged 43-86 (69 ± 10) years. The measured values of the spectral quantitative parameters of the CRAC were consistent within the observer (ICC range: 0.800-0.926). The 40 keV-AP, IC-AP, NIC-AP, 40 keV-VP, and IC-VP were significantly different among the different differentiation grades in the CRAC (P = 0.040, AUC = 0.673; P = 0.035, AUC = 0.684; P = 0.031, AUC = 0.639; P = 0.044, AUC = 0.663 and P = 0.035, AUC = 0.666, respectively). A statistically significant difference was observed in 40 keV-VP, 100 keV-VP, Zeff-VP, IC-VP, and λHU-VP between LVI-positive and LVI-negative patients (P = 0.003, AUC = 0.688; P = 0.015, AUC = 0.644; P = 0.001, AUC = 0.688; P = 0.001, AUC = 0.703 and P = 0.003, AUC = 0.677, respectively). There were no statistically significant differences in the values of the spectral parameters of the PNI state of patients with CRAC (P > 0.05). CONCLUSION The quantitative parameters of SDCT had good diagnostic efficacy in differentiating between different grades and statuses of LVI in patients with CRAC; however, SDCT did not have value for identifying the state of PNI.
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Affiliation(s)
- Jinghua Chen
- Department of Radiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Lei Ni
- Department of Radiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Jingjing Gong
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jie Wu
- Department of Radiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Tingting Qian
- Department of Pathology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Mengjia Wang
- Department of Pathology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Jian Huang
- Department of Radiology, Taicang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Taicang, China
| | - Kefu Liu
- Department of Radiology, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.
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Lu W, Tan X, Zhong Y, Wang P, Ge Y, Zhang H, Hu S. Spectral CT in the evaluation of perineural invasion status in rectal cancer. Jpn J Radiol 2024; 42:1012-1020. [PMID: 38709434 DOI: 10.1007/s11604-024-01575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 04/15/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE To investigate whether preoperative spectral CT quantitative parameters can assess perineural invasion (PNI) status in rectal cancer. METHODS Sixty-two patients diagnosed with rectal cancer who underwent preoperative spectral CT were retrospectively enrolled and divided into positive and negative PNI groups according to histopathologic results. The CT attenuation value (HU) of virtual monochromatic images (40-70 keV), spectral curve slope (K(HU)), effective atomic number (Zeff), and iodine concentration (IC) from spectral CT were compared between these two groups using t test or rank sum test. A nomogram was established by incorporating the independent predictors to assess the overall diagnostic efficacy. The area under the ROC curves (AUCs) were compared using the DeLong test. RESULTS The preoperative spectral CT parameters (40-70 keV attenuation, K(HU), Zeff, and IC) were significantly higher in the PNI-positive group compared to the PNI-negative group (all p < 0.05). The highest predictive efficiency of PNI was observed at 40 keV attenuation, with an area under the curve (AUC), sensitivity, specificity, and accuracy of 0.847, 81.8%, 72.5%, and 75.8%, respectively. Binary logistic regression demonstrated that the clinical feature (cN stage) and 40 keV attenuation were independent predictors of PNI status. The nomogram incorporating these two predictors (cN stage and 40 keV attenuation) exhibited the best evaluation efficacy, with an AUC, sensitivity, specificity, and accuracy of 0.885, 86.4%, 77.5%, and 80.6%. CONCLUSION Spectral CT quantitative parameters proved valuable in the preoperative assessment of PNI status in rectal cancer patients. The combination of spectral CT parameters and clinical features could further enhance the diagnostic efficiency.
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Affiliation(s)
- Wenzheng Lu
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Xiaoying Tan
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Yanqi Zhong
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Peng Wang
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Yuxi Ge
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Heng Zhang
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China
| | - Shudong Hu
- Department of Radiology, Affiliated Hospital, Jiangnan University, No.1000, Hefeng Road, Wuxi, Jiangsu, 214000, China.
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Xu Z, Huang L, Yang Y, Cai Z, Chen M, Lu R, Ouyang Y, Hong Z, Huang W, Xu Z. Discriminating atypical parotid carcinoma and pleomorphic adenoma utilizing extracellular volume fraction and arterial enhancement fraction derived from contrast-enhanced CT imaging: A multicenter study. Cancer Med 2024; 13:e7407. [PMID: 38899534 PMCID: PMC11187748 DOI: 10.1002/cam4.7407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/03/2024] [Accepted: 06/07/2024] [Indexed: 06/21/2024] Open
Abstract
OBJECTIVES To investigate the added value of extracellular volume fraction (ECV) and arterial enhancement fraction (AEF) derived from enhanced CT to conventional image and clinical features for differentiating between pleomorphic adenoma (PA) and atypical parotid adenocarcinoma (PCA) pre-operation. METHODS From January 2010 to October 2023, a total of 187 cases of parotid tumors were recruited, and divided into training cohort (102 PAs and 51 PCAs) and testing cohort (24 PAs and 10 atypical PCAs). Clinical and CT image features of tumor were assessed. Both enhanced CT-derived ECV and AEF were calculated. Univariate analysis identified variables with statistically significant differences between the two subgroups in the training cohort. Multivariate logistic regression analysis with the forward variable selection method was used to build four models (clinical model, clinical model+ECV, clinical model+AEF, and combined model). Diagnostic performances were evaluated using receiver operating characteristic (ROC) curve analyses. Delong's test compared model differences, and calibration curve and decision curve analysis (DCA) assessed calibration and clinical application. RESULTS Age and boundary were chosen to build clinical model, and to construct its ROC curve. Amalgamating the clinical model, ECV, and AEF to establish a combined model demonstrated superior diagnostic effectiveness compared to the clinical model in both the training and test cohorts (AUC = 0.888, 0.867). There was a significant statistical difference between the combined model and the clinical model in the training cohort (p = 0.0145). CONCLUSIONS ECV and AEF are helpful in differentiating PA and atypical PCA, and integrating clinical and CT image features can further improve the diagnostic performance.
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Affiliation(s)
- Zhen‐Yu Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Lin‐Wen Huang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yun‐Jun Yang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Ping Cai
- Department of RadiologyShunde Hospital, Southern Medical University (The First People's Hospital of Shunde)FoshanChina
| | - Mei‐Lin Chen
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Rui‐Liang Lu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Yong‐Xi Ouyang
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Zhen‐Kai Hong
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
| | - Wei‐Jun Huang
- Department of UltrasoundThe First People's Hospital of FoshanFoshanChina
| | - Zhi‐Feng Xu
- Department of RadiologyThe First People's Hospital of FoshanFoshanChina
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Zhan Y, Wang Y, Wang P, Wang Y, Ni X, Wang J, Tang Z. Pretreatment dual-energy CT for predicting early response to induction chemotherapy and survival in nasopharyngeal carcinoma. Eur Radiol 2023; 33:9052-9062. [PMID: 37405505 DOI: 10.1007/s00330-023-09837-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/05/2023] [Accepted: 04/14/2023] [Indexed: 07/06/2023]
Abstract
OBJECTIVES To evaluate the predictive performance of pretreatment dual-energy CT (DECT) for early response to induction chemotherapy and survival in nasopharyngeal carcinoma (NPC). METHODS In this retrospective study, 56 NPC patients who underwent pretreatment DECT scans with posttreatment follow-up were enrolled. The DECT-derived normalised iodine concentration (nIC), effective atomic number (Zeff), 40-180 keV (20 keV interval), and Mix-0.3 value of the tumour lesions were measured to predict the early response to induction chemotherapy and survival in nasopharyngeal carcinoma. The Mann‒Whitney U test, ROC analysis, Kaplan‒Meier method with log-rank test, and Cox proportional hazards model were performed to evaluate the predictive performance of DECT parameters, respectively. RESULTS Among all DECT-derived parameters, ROC analysis showed the predictive performances of nIC and Zeff values for early objective response to induction chemotherapy (AUCs of 0.803 and 0.826), locoregional failure-free survival (AUCs of 0.786 and 0.767), progression-free survival (AUCs of 0.856 and 0.731) and overall survival (AUCs of 0.765 and 0.799) in NPC patients, respectively (all p < 0.05). Moreover, multivariate analysis showed that a high nIC value was an independent predictor of poor survival in NPC. In addition, survival analysis indicated that NPC patients with higher nIC values in primary tumours tend to have lower 5-year locoregional failure-free survival, progression-free survival and overall survival rates than those with lower nIC values. CONCLUSIONS DECT-derived nIC and Zeff values can predict early response to induction chemotherapy and survival in NPC; in particular, a high nIC value is an independent predictive factor of poor survival in NPC. CLINICAL RELEVANCE STATEMENT Preoperative dual-energy computed tomography may provide predictive value for early response and survival outcomes in patients with nasopharyngeal carcinoma, and facilitate their clinical management. KEY POINTS • Pretreatment dual-energy computed tomography helps to predict early response to therapy and survival in NPC. • NIC and Zeff values derived from dual-energy computed tomography can predict early objective response to induction chemotherapy and survival in NPC. • A high nIC value is an independent predictive factor of poor survival in NPC.
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Affiliation(s)
- Yang Zhan
- Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200032, China
- Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yuzhe Wang
- Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Peng Wang
- Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
- Department of Radiology, Affiliated Hospital of Jiangnan University, Wuxi, 214122, China
| | - Yin Wang
- Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Xiaochen Ni
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Jie Wang
- Department of Radiation Oncology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
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Tan Z, Mei H, Qin C, Zhang X, Yang M, Zhang L, Wang J. The diagnostic value of dual-layer CT in the assessment of lymph nodes in lymphoma patients with PET/CT as a reference standard. Sci Rep 2023; 13:18323. [PMID: 37884597 PMCID: PMC10603090 DOI: 10.1038/s41598-023-45198-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 10/17/2023] [Indexed: 10/28/2023] Open
Abstract
This study aimed to evaluate the diagnostic performances of dual-layer CT (DLCT) for the identification of positive lymph nodes (LNs) in patients with lymphoma and retrospectively included 1165 LNs obtained by biopsy from 78 patients with histologically proven lymphoma, who underwent both pretreatment DLCT and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). According to 18F-FDG PET/CT findings as a reference standard, cases were categorized into the LN-negative and LN-positive groups. LNs were then randomly divided at a ratio of 7:3 into the training (n = 809) and validation (n = 356) cohorts. The patients' clinical characteristics and quantitative parameters including spectral curve slope (λHU), iodine concentration (IC) on arterial phase (AP) and venous phase (VP) images were compared between the LN-negative and LN-positive groups using Chi-square test, t-test or Mann-Whitney U test for categorical variables or quantitative parameters. Multivariate logistic regression analysis with tenfold cross-validation was performed to establish the most efficient predictive model in the training cohort. The area under the curve (AUC) was used to evaluate the diagnostic value of the predictive model, and differences in AUC were determined by the DeLong test. Moreover, the predictive model was validated in the validation cohort. Repeatability analysis was performed for LNs using intraclass correlation coefficients (ICCs). In the training cohort, long diameter (LD) had the highest AUC as an independent factors compared to other parameter in differentiating LN positivity from LN negativity (p = 0.006 to p < 0.001), and the AUC of predictive model jointly involving LD and λHU-AP was significantly elevated (AUC of 0.816, p < 0.001). While the AUC of predictive model in the validation cohort was 0.786. Good to excellent repeatability was observed for all parameters (ICC > 0.75). The combination of DLCT with morphological and functional parameters may represent a potential imaging biomarker for detecting LN positivity in lymphoma.
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Affiliation(s)
- Zhengwu Tan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Heng Mei
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chunxia Qin
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiao Zhang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Key Laboratory of Molecular Imaging, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Ming Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Lan Zhang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China
| | - Jing Wang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No 1277, Jiefang Avenue, Wuhan, Hubei, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, China.
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12
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Luo X, E Y, Wu J, Lu C, Zhang J. Analysis of prognostic factors in different grades of histologic differentiation in colorectal cancer patients receiving preoperative neoadjuvant chemotherapy and establishment of prognostic nomograms for moderately differentiated grade. Int J Colorectal Dis 2023; 38:237. [PMID: 37747505 DOI: 10.1007/s00384-023-04539-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVE The aim of this study is to analyze the differences in independent prognostic factors of cancer-specific survival (CSS) and overall survival (OS) in patients with different grades of histologic differentiation of colorectal cancer (CRC) who received preoperative neoadjuvant chemotherapy (NAC) and to establish a nomogram for predicting postoperative survival based on moderately differentiated CRC. METHODS We analyzed CRC patients from the SEER database who received NAC before operation between 2010 and 2015. The Kaplan-Meier curves were drawn to describe the differences in CSS and OS of CRC patients with different histologic grades of differentiation. Cox regression analysis was used to determine the independent prognostic factors. Nomograms were established to predict CSS and OS at 3 and 5 years by integrating independent prognostic factors. The calibration curve, receiver operating characteristic (ROC) curve, and C-index were used to verify nomograms. RESULTS A total of 6481 patients with CRC who received preoperative NAC were included in this study. Patients with different grades of histologic differentiation had significant differences in CSS and OS (P < 0.001), and the independent prognostic factors of different grades of histologic differentiation showed heterogeneity. In patients with moderately differentiated grade CRC, the independent prognostic factors for CSS and OS were age, race, marital status, serum carcinoembryonic antigen (CEA) level before treatment, site of primary tumor, histologic type, pT stage, pN stage, liver metastasis, and lung metastasis. Nomograms were established based on the independent prognostic factors of moderately differentiated grade CRC, and its calibration curves, area under the curve (AUC), and C-index showed good prediction accuracy. CONCLUSIONS The independent prognostic factors of CSS and OS are different in patients with different grades of histologic differentiation of CRC who received NAC before the operation. Nomograms can be used to predict the survival of patients with moderately differentiated grade CRC who received preoperative NAC and to assist clinicians in making clinical decisions.
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Affiliation(s)
- Xiagang Luo
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang jia Yuan Road, Nanjing, 210011, China
| | - Yimin E
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang jia Yuan Road, Nanjing, 210011, China
| | - Jie Wu
- Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chen Lu
- Department of General Surgery, Sir Run Run Hospital Nanjing Medical University, Nanjing, China
| | - Jianping Zhang
- Department of General Surgery, The Second Affiliated Hospital of Nanjing Medical University, 121 Jiang jia Yuan Road, Nanjing, 210011, China.
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13
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Yuan X, Quan X, Che XL, Xu LL, Yang CM, Zhang XD, Shu J. Preoperative prediction of the lymphovascular tumor thrombus of colorectal cancer with the iodine concentrations from dual-energy spectral CT. BMC Med Imaging 2023; 23:103. [PMID: 37537532 PMCID: PMC10398985 DOI: 10.1186/s12880-023-01060-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 07/21/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The aim of this study was to explore application value of iodine concentration from dual-energy spectral computed tomography (DESCT) in preoperative prediction of lymphovascular tumor thrombus in patients with colorectal cancer (CRC). METHODS We finally retrospectively analyzed 50 patients with CRC who underwent abdominal DESCT before receiving any preoperative treatment and underwent surgery to obtain pathological specimens which were stained with hematoxylin-eosin (HE) staining. According to the presence of cancer cell nests in blood vessels and lymphatic vessels, the subjects were divided into the positive group and negative group of lymphovascular tumor thrombus. Two radiologists independently measured the normalized iodine concentration (NIC) values, effective atomic number (Zeff) and CT values of virtual monochromatic images (VMIs) at 40-90 keV of the primary tumors in the arterial phase (AP) and venous phase (VP). Used SPSS 17.0 to calculate the receiver operating characteristic (ROC) curve to evaluate diagnostic value. RESULTS The patients were divided into lymphovascular tumor thrombus positive group(n = 16) and negative group(n = 34). The values of NIC-AP and NIC-VP in the positive group were 0.17 ± 0.09, 0.51 ± 0.13, respectively. And those in the negative group were 0.15 ± 0.06, 0.43 ± 0.12, respectively. There was significant difference in NIC-VP value between the two groups (p = 0.039), but there was no significant difference in NIC-AP value (p = 0.423). The optimal threshold value of NIC-VP value for diagnosis of lymphovascular tumor thrombus was 0.364. The sensitivity was 68.8% and the specificity was 67.6%. CONCLUSIONS The NIC-VP value of DESCT can be used to predict the presence or absence of the lymphovascular tumor thrombus in CRC patients before operation, which is helpful to select the best treatment scheme and evaluate its prognosis.
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Affiliation(s)
- Xiang Yuan
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China
| | - Xin Quan
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China
| | - Xiao-Ling Che
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China
| | - Lu-Lu Xu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China
| | - Chun-Mei Yang
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China
| | | | - Jian Shu
- Department of Radiology, The Affiliated Hospital of Southwest Medical University, No.25 taiping street, 64600, Luzhou, China.
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14
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Arico' FM, Trimarchi R, Portaluri A, Barilla' C, Migliaccio N, Bucolo GM, Cicero G, Sofia C, Booz C, Vogl TJ, Marino MA, Ascenti V, D'Angelo T, Mazziotti S, Ascenti G. Virtual monoenergetic dual-layer dual-energy CT images in colorectal cancer: CT diagnosis could be improved? LA RADIOLOGIA MEDICA 2023; 128:891-899. [PMID: 37310558 DOI: 10.1007/s11547-023-01663-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/05/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE To compare conventional CT images and virtual monoenergetic images (VMI) at dual-layer dual-energy CT (dlDECT) in patients with colorectal cancer (CRC) through quantitative analysis and to investigate the added value of VMI. MATERIAL AND METHODS Sixty-six consecutive patients with histologically documented CRC and available VMI reconstructions were retrospectively investigated. Subsequently, forty-two patients, without any colonic disease at colonoscopy, were selected as control group. Conventional CT images and VMI reconstructions at energy levels ranging from 40 (VMI40) to 100 keV (VMI100) in 10 keV increments, were obtained from the late arterial phase. First, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were obtained to select the best VMI reconstruction. Finally, the diagnostic accuracy of conventional CT and VMI40 in late arterial phase was evaluated. RESULTS On quantitative analysis, SNR and CNR were higher for VMI40 (19.5 ± 7.7 and 11.8 ± 6.2, respectively) with statistically significant differences compared to conventional CT (P < 0.05) and all the other VMI reconstructions (P < 0.05), except for VMI50 (P > 0.05). The addition of VMI40 to conventional CT images significantly improved the area under the curve (AUC) for the diagnosis of CRC, increasing it from 0.875 to 0.943 for reader 1 (P < 0.05) and from 0.916 to 0.954 for reader 2 (P < 0.05). The improvement was greater in the less experienced radiologist (0.068) compared to the more experienced one (0.037). CONCLUSION VMI40 has showed the highest quantitative image parameters. Furthermore, the use of VMI40 can lead to a significant improvement in the diagnostic performance for detecting CRC.
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Affiliation(s)
- Francesco Marcello Arico'
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Renato Trimarchi
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy.
| | - Antonio Portaluri
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Claudia Barilla'
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Nicola Migliaccio
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giuseppe Mauro Bucolo
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giuseppe Cicero
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Carmelo Sofia
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Christian Booz
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Thomas J Vogl
- Division of Experimental Imaging, Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt, Germany
| | - Maria Adele Marino
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Velio Ascenti
- Postgraduate School of Radiodiagnostics, Policlinico Universitario, University of Milan, Milan, Italy
| | - Tommaso D'Angelo
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Silvio Mazziotti
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
| | - Giorgio Ascenti
- Department of Biomedical Sciences and Morphologic and Functional Imaging, Policlinico Universitario G.Martino, University of Messina, Via Consolare Valeria 1, 98123, Messina, Italy
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15
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Li Q, Bao J, Zhang Y, Dou Y, Liu A, Liu M, Wu H, Wu J, Zhao L, Yang Z, Zhu L, Gao W, Zhao W, Wei M, Hao F. Predictive value of CT-based extracellular volume fraction in the preoperative pathologic grading of rectal adenocarcinoma: A preliminary study. Eur J Radiol 2023; 163:110811. [PMID: 37062204 DOI: 10.1016/j.ejrad.2023.110811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 03/29/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Abstract
OBJECTIVE This study aimed to investigate whether the extracellular volume fraction (ECV) determined using enhanced computed tomography (CT) can predict the pathologic grade of rectal adenocarcinoma. METHODS We prospectively analyzed 43 patients with rectal adenocarcinoma confirmed surgically and pathologically and who had undergone preoperative enhanced CT imaging. The plain, arterial, venous, and balance phase values were recorded, and the absolute contrast-enhanced CT differences ΔS1 = HUarterial phase-HUplain scan, ΔS2 = HUvenous phase-HUplain scan, ΔS3 = HUbalance phase-HUplain scan were obtained. The ECV of the primary lesion was calculated by measuring the CT values of the regions of interest in the plain and balance phases. Patients were allocated to either a low-grade or a high-grade group based on the histologic grading standard for colorectal adenocarcinoma (nonspecial type, World Health Organization 2010 standard). The differences in the parameters between the two groups were evaluated for statistical significance. A receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficiency. RESULTS The 43 enrolled patients [12 in the high-grade group (27.9%) and 31 in the low-grade group (72.1%)] had an average age of 64.47 years. The arterial phase (P = 0.005) as well as ΔS1 (P = 0.006), ΔS3 (P = 0.021), and ECV (P＜ 0.001) differed significantly between the high-grade and low-grade groups, with ECV (P＜ 0.001) and ΔS3 (P = 0.042) being positively correlated with the pathologic grade and arterial phase (P = 0.025) and ΔS1 (P = 0.005) being negatively correlated. The ROC curve demonstrated that the best efficacy in evaluating the pathologic grade of rectal cancer was achieved by ECV, with an area under the curve of 0.892 (95% confidence interval: 0.757-1.000). The diagnostic threshold was 34.42%, sensitivity was 91.7%, and specificity was 83.9%. CONCLUSION The use of enhanced CT to obtain ECV is helpful in predicting the pathologic grade of rectal cancer; however, this result has to be confirmed in a study with a larger sample size.
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Affiliation(s)
- Qingyang Li
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Jiaqi Bao
- Department of Oncology, Inner Mongolia Autonomous Region People's Hospital, Hohhot 010020, China
| | - Yuqi Zhang
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Yana Dou
- Computed Tomography System Division, Siemens Medical Systems Ltd, Beijing 100102, China
| | - Aishi Liu
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Miaomiao Liu
- Department of Radiology, Shaw Hospital Affiliated to Zhejiang University, Hangzhou 310016, China
| | - Hui Wu
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Jing Wu
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Lei Zhao
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Zhenxing Yang
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Lu Zhu
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Wei Gao
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Wei Zhao
- Department of Radiology, Linfen People's Hospital, Shanxi 041000, China
| | - Mingjie Wei
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China
| | - Fene Hao
- Department of Radiology, The Affiliated Hospital of Inner Mongolia Medical University, Huhhot 010050, China.
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Yang X, Hu H, Zhang F, Li D, Yang Z, Shi G, Lu G, Jiang Y, Yang L, Wang Y, Duan X, Shen J. Preoperative Prediction of the Aggressiveness of Oral Tongue Squamous Cell Carcinoma with Quantitative Parameters from Dual-Energy Computed Tomography. Front Oncol 2022; 12:904471. [PMID: 35814448 PMCID: PMC9260668 DOI: 10.3389/fonc.2022.904471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES To determine whether quantitative parameters derived from dual-energy computed tomography (DECT) were predictive of the aggressiveness of oral tongue squamous cell carcinoma (OTSCC) including the pathologic stages, histologic differentiation, lymph node status, and perineural invasion (PNI). METHODS Between August 2019 and March 2021, 93 patients (mean age, 54.6 ± 13.8 years; 66 men) with pathologically diagnosed OTSCC were enrolled in this prospective study. Preoperative DECT was performed and quantitative parameters (e.g., slope of the spectral Hounsfield unit curve [λHu], normalized iodine concentration [nIC], normalized effective atomic number [nZeff], and normalized electron density [nRho]) were measured on arterial phase (AP) and venous phase (VP) DECT imaging. Quantitative parameters from DECT were compared between patients with different pathologic stages, histologic differentiation, lymph node statuses, and perineural invasion statuses. Logistic regression analysis was utilized to assess independent parameters and the diagnostic performance was analyzed by the receiver operating characteristic curves (ROC). RESULTS λHu and nIC in AP and λHu, nZeff, and nIC in VP were significantly lower in stage III-IV lesions than in stage I-II lesions (p < 0.001 to 0.024). λHu in VP was an independent predictor of tumor stage with an odds ratio (OR) of 0.29, and area under the curve (AUC) of 0.80. λHu and nIC were higher in well-differentiated lesions than in poorly differentiated lesions (p < 0.001 to 0.021). The nIC in VP was an independent predictor of histologic differentiation with OR of 0.31, and AUC of 0.78. λHu and nIC in VP were lower in OTSCCs with lymph node metastasis than those without metastasis (p < 0.001 to 0.005). λHu in VP was the independent predictor of lymph node status with OR of 0.42, and AUC of 0.74. No significant difference was found between OTSCCs without PNI and those with PNI in terms of the quantitative DECT parameters. CONCLUSION DECT can be a complementary means for the preoperative prediction of the aggressiveness of OTSCC.
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Affiliation(s)
- Xieqing Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Huijun Hu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Fang Zhang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Dongye Li
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Zehong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Guangzi Shi
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Guoxiong Lu
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yusong Jiang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Lingjie Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Yu Wang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Xiaohui Duan
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Jun Shen
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Medical Research Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China
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Wang D, Zhuang Z, Wu S, Chen J, Fan X, Liu M, Zhu H, Wang M, Zou J, Zhou Q, Zhou P, Xue J, Meng X, Ju S, Zhang L. A Dual-Energy CT Radiomics of the Regional Largest Short-Axis Lymph Node Can Improve the Prediction of Lymph Node Metastasis in Patients With Rectal Cancer. Front Oncol 2022; 12:846840. [PMID: 35747803 PMCID: PMC9209707 DOI: 10.3389/fonc.2022.846840] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 05/19/2022] [Indexed: 12/24/2022] Open
Abstract
ObjectiveTo explore the value of dual-energy computed tomography (DECT) radiomics of the regional largest short-axis lymph nodes for evaluating lymph node metastasis in patients with rectal cancer.Materials and MethodsOne hundred forty-one patients with rectal cancer (58 in LNM+ group, 83 in LNM- group) who underwent preoperative total abdominal DECT were divided into a training group and testing group (7:3 ratio). After post-processing DECT venous phase images, 120kVp-like images and iodine (water) images were obtained. The highest-risk lymph nodes were identified, and their long-axis and short-axis diameter and DECT quantitative parameters were measured manually by two experienced radiologists who were blind to the postoperative pathological results. Four DECT parameters were analyzed: arterial phase (AP) normalized iodine concentration, AP normalized effective atomic number, the venous phase (VP) normalized iodine concentration, and the venous phase normalized effective atomic number. The carcinoembryonic antigen (CEA) levels were recorded one week before surgery. Radiomics features of the largest lymph nodes were extracted, standardized, and reduced before modeling. Radomics signatures of 120kVp-like images (Rad-signature120kVp) and iodine map (Rad-signatureImap) were built based on Logistic Regression via Least Absolute Shrinkage and Selection Operator (LASSO).ResultsEight hundred thirty-three features were extracted from 120kVp-like and iodine images, respectively. In testing group, the radiomics features based on 120kVp-like images showed the best diagnostic performance (AUC=0.922) compared to other predictors [CT morphological indicators (short-axis diameter (AUC=0.779, IDI=0.262) and long-axis diameter alone (AUC=0.714, IDI=0.329)), CEA alone (AUC=0.540, IDI=0.414), and normalized DECT parameters alone (AUC=0.504-0.718, IDI=0.290-0.476)](P<0.05 in Delong test). Contrary, DECT iodine map-based radiomic signatures showed similar performance in predicting lymph node metastasis (AUC=0.866). The decision curve showed that the 120kVp-like-based radiomics signature has the highest net income.ConclusionPredictive model based on DECT and the largest short-axis diameter lymph nodes has the highest diagnostic value in predicting lymph node metastasis in patients with rectal cancer.
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Affiliation(s)
- Dongqing Wang
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Zijian Zhuang
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Shuting Wu
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Jixiang Chen
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Xin Fan
- Department of General Surgery, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Mengsi Liu
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Haitao Zhu
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Ming Wang
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Jinmei Zou
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Qun Zhou
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Peng Zhou
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Jing Xue
- School of Medicine, Jiangsu University, Zhenjiang, China
| | - Xiangpan Meng
- School of Medicine, Southeast University, Nanjing, China
- Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Shenghong Ju
- School of Medicine, Southeast University, Nanjing, China
- Department of Radiology, Zhongda Hospital, Southeast University, Nanjing, China
| | - Lirong Zhang
- Department of Medical Imaging, The Affiliated Hospital of Jiangsu University, Zhenjiang, China
- School of Medicine, Southeast University, Nanjing, China
- *Correspondence: Lirong Zhang,
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Geng D, Chen X, Zhao XG, Xu XQ, Su GY, Zhou Y, Chen HB, Wu FY. Laryngeal and hypopharyngeal squamous cell carcinoma: association between quantitative parameters derived from dual-energy CT and histopathological prognostic factors. Acta Radiol 2022:2841851221095237. [PMID: 35502811 DOI: 10.1177/02841851221095237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dual-energy computed tomography (DECT) can provide objective evaluation of laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC). PURPOSE To investigate the relationship between quantitative parameters acquired from DECT and histopathological prognostic factors in LHSCC. MATERIAL AND METHODS A total of 65 patients with LHSCC who underwent arterial phase and venous phase DECT scans were retrospectively enrolled. Iodine concentration (IC) and normalized IC (NIC) of the tumor were calculated in both the arterial (ICA and NICA) and venous (ICV and NICV) phases, and compared among different pathological grades, T stages, and lymph node stages. Receiver operating characteristic (ROC) curves were generated to evaluate their diagnostic performance. RESULTS There were significantly differences on ICA and NICA among three pathological grades (ICA, P = 0.001; NICA, P = 0.002). For differentiating moderately and poorly differentiated from well-differentiated LHSCC using ICA and NICA, the areas under curve (AUCs) were 0.753 and 0.726, respectively. High T stage (T3/4) LHSCC showed significantly higher ICA (P = 0.012) and NICA (P = 0.005) than low T stage (T1/2) LHSCC. The AUCs of the ICA and NICA were 0.674 and 0.703, respectively, in discriminating high from low T stage LHSCC. Lymph node metastasis (LNM)-positive (N1/2/3) LHSCC showed significantly higher ICA (P = 0.008) and NICA (P = 0.003) than LNM-negative (N0) LHSCC. For discriminating the LNM-positive from the LNM-negative group using ICA and NICA, the AUCs were 0.697 and 0.744, respectively. CONCLUSION ICA and NICA might be helpful in assessing histopathological prognostic factors in patients with LHSCC.
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Affiliation(s)
- Di Geng
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xi Chen
- Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xing-Guo Zhao
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Xiao-Quan Xu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Guo-Yi Su
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Yan Zhou
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Hai-Bing Chen
- Department of Otolaryngology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
| | - Fei-Yun Wu
- Department of Radiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, PR China
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Wang YL, Zhang HW, Mo YQ, Zhong H, Liu WM, Lei Y, Lin F. Application of dual-layer spectral detector computed tomography to evaluate the expression of Ki-67 in colorectal cancer. J Chin Med Assoc 2022; 85:610-616. [PMID: 35286294 DOI: 10.1097/jcma.0000000000000706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Compared with traditional computed tomography (CT), dual-layer spectral detector CT (SDCT) shows significant improvement in imaging soft tissues of the digestive tract. This work aimed to explore the application of SDCT to evaluate the expression of the molecular marker Ki-67 in colorectal cancer. METHODS We retrospectively analyzed the imaging data of the SDCT (IQon Spectral CT; Philips Healthcare) of 45 patients with colorectal cancer in our centre. We used Spearman's test for the imaging parameters (reconstruction of 40, 70, and 100 keV virtual monoenergetic images [VMIs] and the slope of the Hounsfield unit attenuation plot [VMI Slope] based on venous phase CT images, the arterial phase iodine concentration [AP-IC] and venous phase iodine concentration [VP-IC], and the effective atomic number [Z effect]) and correlation analysis for the Ki-67 index. Multivariate logistic regression was used to eliminate confounding factors. We evaluated the expression level of Ki-67 and drew the receiver operating characteristic curve. RESULTS The 40-keV VMI, VMI Slope, and AP-IC were found to better reflect the Ki-67 index in patients with colorectal cancer with statistical significance. The 40-keV VMI (r = -0.612, p < 0.001) and VMI Slope (r = -0.523, p < 0.001) were negatively correlated with the Ki-67 index, and AP-IC (r = 0.378, p = 0.010) was positively correlated with the Ki-67 index. The other indexes (p > 0.05) were not statistically significant. The SDCT parameters demonstrated good performance, with area under curves of 0.785 for 40-keV VMI and 0.752 for AP-IC. CONCLUSION The SDCT parameters 40-keV VMI and AP-IC can be used for preliminary evaluation of the Ki-67 index in colorectal cancer.
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Affiliation(s)
- Yu-Li Wang
- Department of Radiology, The First Affiliated Hospital of Shenzhen University, Health Science Center, Shenzhen Second People's Hospital, Shenzhen, China
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Zhang H, Zou Y, Tian F, Li W, Ji X, Guo Y, Li Q, Sun S, Sun F, Shen L, Xia S. Dual-energy CT may predict post-operative recurrence in early-stage glottic laryngeal cancer: a novel nomogram and risk stratification system. Eur Radiol 2022; 32:1921-1930. [PMID: 34762148 DOI: 10.1007/s00330-021-08265-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/13/2021] [Accepted: 06/30/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To establish and validate a predictive model integrating with clinical and dual-energy CT (DECT) variables for individual recurrence-free survival (RFS) prediction in early-stage glottic laryngeal cancer (EGLC) after larynx-preserving surgery. METHODS This retrospective study included 212 consecutive patients with EGLC who underwent DECT before larynx-preserving surgery between January 2015 and December 2018. Using Cox proportional hazard regression model to determine independent predictors for RFS and presented on a nomogram. The model's performance was assessed using Harrell's concordance index (C-index), time-dependent area under curve (TD-AUC) plot, and calibration curve. A risk stratification system was established using the nomogram with median scores of all cases to divide all patients into two prognostic groups. RESULTS Recurrence occurred in 39/212 (18.4%) cases. Normalized iodine concentration in arterial (NICAP) and venous phases (NICVP) were verified as significant predictors of RFS in multivariate Cox regression (hazard ratio [HR], 4.2; 95% confidence interval [CI]: 2.3, 7.7, p < .001 and HR, 3.0; 95% CI: 1.5, 5.9, p = .002, respectively). Nomogram based on clinical and DECT variables was better than did only clinical variables. The prediction model proved well-calibrated and had good discriminative ability in the training and validation samples. A risk stratification system was built that could effectively classify EGLC patients into two risk groups. CONCLUSIONS DECT could provide independent RFS indicators in patients with EGLC, and the nomogram based on DECT and clinical variables was useful in predicting RFS at several time points. KEY POINTS • Dual-energy CT(DECT) variables can predict recurrence-free survival (RFS) after larynx-preserving surgery in patients with early-stage glottic laryngeal cancer (EGLC). • The model that integrates clinical and DECT variables predicted RFS better than did only clinical variables. • A risk stratification system based on the nomogram could effectively classify EGLC patients into two risk groups.
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Affiliation(s)
- Huanlei Zhang
- Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
- Department of Radiology, Yidu Central Hospital of Weifang, No. 4138 Linglongshan South Road, Qingzhou City, 262500, Shandong, China
| | - Ying Zou
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 314 Anshan West Road, Nankai District, Tianjin, 300193, China
| | - Fengyue Tian
- Department of Radiology, Affiliated Hospital of Nankai University (Tianjin No. 4 Hospital), Tianjin, 300222, China
| | - Wenfei Li
- Department of Radiology, The First Hospital of Qinhuangdao, No. 258 Wenhua Road, Haigang District, Qinhuangdao, 066000, China
| | - Xiaodong Ji
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Yu Guo
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Qing Li
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
| | - Shuangyan Sun
- Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
- Department of Radiology, Jilin Cancer Hospital, No. 1066 JinHu Road, Chaoyang District, , Changchun, 130000, China
| | - Fang Sun
- Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
- Department of Ultrasonography, Binzhou Medical University Hospital, No. 661 Huanghe 2nd Road, Binzhou City, Shandong, 256603, China
| | - Lianfang Shen
- Department of Radiology, First Central Clinical College, Tianjin Medical University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China
- Department of Radiology, Yidu Central Hospital of Weifang, No. 4138 Linglongshan South Road, Qingzhou City, 262500, Shandong, China
| | - Shuang Xia
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, No. 24 Fu Kang Road, Nankai District, Tianjin, 300192, China.
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Han X, Li B, Sun M, Li J, Li Y, Liu A. Application of contrast-enhanced dual-energy spectral CT for differentiating borderline from malignant epithelial ovarian tumours. Clin Radiol 2021; 76:585-592. [PMID: 34059294 DOI: 10.1016/j.crad.2021.04.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/16/2021] [Indexed: 10/21/2022]
Abstract
AIM To investigate the value of contrast-enhanced dual-energy spectral computed tomography (CT) in differentiating borderline epithelial ovarian tumours (BEOTs) from malignant epithelial ovarian tumours (MEOTs). MATERIALS AND METHODS Sixty patients who underwent pelvic contrast-enhanced spectral CT were divided into two groups for analysis based on the tumour types confirmed at histopathological examination (26 BEOTs and 34 MEOTs). The regions of interest (ROIs) were selected on solid tumour components to measure attenuation values on monochromatic image sets (40-140 keV) in all imaging phases and tumour iodine concentrations (IC) on material decomposition images. Differences in the attenuation value between the unenhanced and contrast-enhanced phases (enhancement degree) and between energy strengths (slope k, k = [attenuation at 40 keV- attenuation at 140 keV]/100) were calculated. All measurements between the two groups were compared with independent t-test. Receiver operating characteristic (ROC) curves were generated to calculate the sensitivity, specificity and area under the ROC curve (AUC). Logistic regression analysis was used to evaluate the diagnostic efficacy of using combined parameters in two-phase contrast-enhanced images. RESULTS In the arterial phase (AP) and venous phase (VP), the BEOTs had significantly lower enhancement than MEOTs from 40 to 100 keV (p<0.05). The k values and IC values both showed significant differences in the AP and VP (p<0.05). Combining parameters in two contrast-enhanced phases provided 80.8% sensitivity and 82.4% specificity in differentiating MEOTs from BEOTs with an AUC of 0.844. CONCLUSION Dual-energy spectral CT provides a multiparametric approach in differentiating BEOTs from MEOTs with the best diagnostic efficacy using combined parameters in the AP and VP images.
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Affiliation(s)
- X Han
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China; Department of Nuclear Medicine, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - B Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - M Sun
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China.
| | - J Li
- GE Healthcare, Shanghai, China
| | - Y Li
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - A Liu
- Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
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Yue X, Jiang Q, Hu X, Cen C, Song S, Qian K, Lu Y, Yang M, Li Q, Han P. Quantitative dual-energy CT for evaluating hepatocellular carcinoma after transarterial chemoembolization. Sci Rep 2021; 11:11127. [PMID: 34045528 PMCID: PMC8160271 DOI: 10.1038/s41598-021-90508-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 05/10/2021] [Indexed: 02/08/2023] Open
Abstract
We aimed to investigate the role of the quantitative parameters of dual-energy computed tomography (DECT) in evaluating patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE). We retrospectively identified 80 HCC patients (mean age, 56 years; 61 men) treated by TACE who received contrast-enhanced DECT and were retreated by TACE within 7 days between November 2018 and December 2019. Taking digital subtraction angiography (DSA) and CT images as reference standard, two readers measured and calculated the values of normalized iodine concentration at arterial phase (NICAP), normalized iodine concentration at portal venous phase (NICPP), iodine concentration difference (ICD), arterial iodine fraction (AIF) and slope of the spectral Hounsfield unit curve (λHu) by placing matched regions of interests (ROIs) within the tumor active area (TAA), adjacent normal hepatic parenchyma (ANHP) and tumor necrotic area (TNA). Differences between the parameters were analyzed by the Kruskal-Wallis H test. Receiver operating characteristic analysis of the parameters performance in differentiating the three tissues types was performed. AIF exhibited a good performance in distinguishing TAA (0.93 ± 0.31) and ANHP (0.18 ± 0.14), the areas under the receiver operating characteristic curve (AUC) was 0.989, while the λHu exhibited an excellent performance in distinguishing TAA (3.32 ± 1.24) and TNA (0.29 ± 0.27), with an AUC of 1.000. In conclusion, quantitative DECT can be effectively used to evaluate the tumor viability in HCC patients treated by TACE.
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Affiliation(s)
- Xiaofei Yue
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Qiqi Jiang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Xuehan Hu
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chunyuan Cen
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Songlin Song
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Kun Qian
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Yuting Lu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Ming Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Qian Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China
| | - Ping Han
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
- Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, China.
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Abstract
PURPOSE OF REVIEW Recent advances in computed tomography (CT), ultrasound (US), magnetic resonance imaging (MRI), and nuclear radiology have improved the diagnosis and characterization of small bowel pathology. Our purpose is to highlight the current status and recent advances in multimodality noninvasive imaging of the small bowel. RECENT FINDINGS CT and MR enterography are established techniques for small bowel evaluation. Dual-energy CT is a novel technique that has shown promise for the mesenteric ischemia and small bowel bleeding. Advanced US techniques and MRI sequences are being investigated to improve assessment of bowel inflammation, treatment response assessment, motility, and mural fibrosis. Novel radiotracers and scanner technologies have made molecular imaging the new reference standard for small bowel neuroendocrine tumors. Computational image analysis and artificial intelligence (AI) have the potential to augment physician expertise, reduce errors and variability in assessment of the small bowel on imaging. SUMMARY Advances in translational imaging research coupled with progress in imaging technology have led to a wider adoption of cross-sectional imaging for the evaluation and management of small bowel entities. Ongoing developments in image acquisition and postprocessing techniques, molecular imaging and AI have the strongest potential to transform the care and outcomes of patients with small bowel diseases.
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Cao Y, Zhang G, Bao H, Ren J, Wang Z, Zhang J, Zhao Z, Yan X, Chai Y, Zhou J. Development of a dual-energy spectral computed tomography-based nomogram for the preoperative discrimination of histological grade in colorectal adenocarcinoma patients. J Gastrointest Oncol 2021; 12:544-555. [PMID: 34012648 DOI: 10.21037/jgo-20-368] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background The usefulness of a dual-energy spectral computed tomography (DESCT)-based nomogram in discriminating between histological grades of colorectal adenocarcinoma (CRAC) is unclear. This study aimed to develop such a nomogram and assess its ability to preoperatively discriminate between histological grades in CRAC patients. Methods Primary tumors monochromatic CT value, iodine concentration (IC) value, and effective atomic number (Eff-Z) in the arterial (AP) and venous phases (VP) were retrospectively compared between patients with high-grade (n=65) and low-grade (n=108) CRAC who underwent preoperative abdominal DESCT. Univariate analysis was used to compare the DESCT parameters and clinical factors between these two patient groups. Statistically significant features in the univariate analysis were included in the multivariate logistic regression model to identify the indicators for building a nomogram that could discriminate between histological grades in CRAC patients. The clinical usefulness of the nomogram and its value for predicting overall survival were statistically evaluated. Results The logistic regression analysis showed that age, clinical T stage, clinical N stage, and IC values in AP and VP were significant independent predictors for high-grade CRAC. A quantitative nomogram developed based on these predictors showed excellent performance for discriminating between the histological grades, with an area under the curve (AUC) of 0.886 and excellent agreement in the calibration curve. The Kaplan-Meier curve for overall survival showed that our nomogram identified a significant difference between the high- and low-risk groups [hazard ratio (HR), 2.188; 95% CI, 1.072-4.465; P=0.027). Conclusions This study presents a nomogram that incorporates DESCT parameters and clinical factors and can potentially be used as a clinical tool for individual preoperative prediction of CRAC histological grade.
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Affiliation(s)
- Yuntai Cao
- Second Clinical School, Lanzhou University, Lanzhou, China.,Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China.,Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China.,Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Guojin Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China.,Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
| | - Haihua Bao
- Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Jialiang Ren
- Department of Pharmaceuticals Diagnosis, GE Healthcare, Beijing, China
| | - Zhan Wang
- Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Jing Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China.,Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
| | - Zhiyong Zhao
- Second Clinical School, Lanzhou University, Lanzhou, China.,Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China
| | - Xiaohong Yan
- Department of Critical Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Yanjun Chai
- Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Junlin Zhou
- Key Laboratory of Medical Imaging of Gansu Province, Lanzhou, China.,Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
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Xu JJ, Taudorf M, Ulriksen PS, Achiam MP, Resch TA, Nielsen MB, Lönn LB, Hansen KL. Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review. Diagnostics (Basel) 2020; 10:diagnostics10100814. [PMID: 33066281 PMCID: PMC7602017 DOI: 10.3390/diagnostics10100814] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 10/04/2020] [Accepted: 10/07/2020] [Indexed: 12/15/2022] Open
Abstract
Dual-energy computed tomography (DECT) can estimate tissue vascularity and perfusion via iodine quantification. The aim of this systematic review was to outline current and emerging clinical applications of iodine quantification within the gastrointestinal tract using DECT. The search was conducted with three databases: EMBASE, Pubmed and The Cochrane Library. This identified 449 studies after duplicate removal. From a total of 570 selected studies, 30 studies were enrolled for the systematic review. The studies were categorized into four main topics: gastric tumors (12 studies), colorectal tumors (8 studies), Crohn’s disease (4 studies) and miscellaneous applications (6 studies). Findings included a significant difference in iodine concentration (IC) measurements in perigastric fat between T1–3 vs. T4 stage gastric cancer, poorly and well differentiated gastric and colorectal cancer, responders vs. non-responders following chemo- or chemoradiotherapy treatment among cancer patients, and a positive correlation between IC and Crohn’s disease activity. In conclusion, iodine quantification with DECT may be used preoperatively in cancer imaging as well as for monitoring treatment response. Future studies are warranted to evaluate the capabilities and limitations of DECT in splanchnic flow.
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Affiliation(s)
- Jack Junchi Xu
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.B.N.); (L.B.L.); (K.L.H.)
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
- Correspondence:
| | - Mikkel Taudorf
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
| | - Peter Sommer Ulriksen
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
| | - Michael Patrick Achiam
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
- Department of Vascular Surgery, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark
| | - Timothy Andrew Resch
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
- Department of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Michael Bachmann Nielsen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.B.N.); (L.B.L.); (K.L.H.)
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
| | - Lars Birger Lönn
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.B.N.); (L.B.L.); (K.L.H.)
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
| | - Kristoffer Lindskov Hansen
- Department of Diagnostic Radiology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.B.N.); (L.B.L.); (K.L.H.)
- Department of Surgical Gastroenterology, Copenhagen University Hospital, Rigshospitalet, 2100 Copenhagen, Denmark; (M.T.); (P.S.U.); (M.P.A.); (T.A.R.)
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Cao Y, Zhang G, Bao H, Zhang S, Zhang J, Zhao Z, Zhang W, Li W, Yan X, Zhou J. Development of a dual-energy spectral CT based nomogram for the preoperative discrimination of mutated and wild-type KRAS in patients with colorectal cancer. Clin Imaging 2020; 69:205-212. [PMID: 32920468 DOI: 10.1016/j.clinimag.2020.08.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/17/2020] [Accepted: 08/24/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To develop a dual-energy spectral CT (DESCT) nomogram for the preoperative identification of KRAS mutation in patients with colorectal cancer (CRC). METHOD One hundred and twenty-four patients who underwent energy spectrum CT pre-operatively were recruited and split into mutated KRAS group (n = 50) and wild-type KRAS group (n = 74). DESCT parameters, including monochromatic CT value, iodine concentration, water concentration, and effective atomic number were measured independently by two reviewers in the arterial, venous, and delayed phases. Normalized iodine concentration (NIC) and slope k of the spectral HU curve were calculated. Evaluate other imaging features such as ATL/LTL ratio, tumor gross pattern, pericolorectal fat invasion (PFI) was also performed by these reviewers. Independent predictors for KRAS mutation were screened out using logistic regression, and these predictors were presented as a nomogram. The receiver operating characteristic (ROC) curve, calibration curve and decision curve analysis (DCA) were used to evaluate the clinical usefulness of the nomogram. RESULTS The slope k in the arterial phase, effective atomic number in the arterial phase, NIC in the venous phase, ATL/LTL ratio and PFI were significant independent predictors for KRAS mutation. Based on these independent predictors, a quantitative nomogram was developed to predict individual KRAS mutation probability. The nomogram had excellent performance with an AUC of 0.848 and excellent calibration. DCA showed that our nomogram has outstanding clinical utility. CONCLUSIONS This study demonstrates that a DESCT based nomogram has potential value for individual preoperative identification of KRAS mutation in CRC patients.
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Affiliation(s)
- Yuntai Cao
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China; Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China; Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China
| | - Guojin Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Haihua Bao
- Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Shenghui Zhang
- Department of Physics, University of Illinois at Chicago, Chicago, USA
| | - Jing Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Zhiyong Zhao
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Wenjuan Zhang
- Second Clinical School, Lanzhou University, Lanzhou, China; Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China
| | - Weixia Li
- Department of Radiology, Affiliated Hospital of Qinghai University, Xining, China
| | - Xiaohong Yan
- Department of Critical Medicine, Affiliated Hospital of Qinghai University, Xining, China
| | - Junlin Zhou
- Key Laboratory of Medical Imaging, Gansu Province, Lanzhou, China; Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China.
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Li Y, Li X, Ren X, Ye Z. Assessment of the aggressiveness of rectal cancer using quantitative parameters derived from dual-energy computed tomography. Clin Imaging 2020; 68:136-142. [PMID: 32599443 DOI: 10.1016/j.clinimag.2020.06.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE To evaluate the value of quantitative parameters derived from dual-energy computed tomography (DECT) in assessing the aggressiveness of rectal cancer. MATERIALS AND METHODS Seventy-eight patients with rectal cancers confirmed by pathology underwent contrasted DECT scans. The normalized iodine concentration (NIC) and normalized water concentration (NWC) of the tumor against artery and tumor sizes were measured. The quantitative parameters were compared and statistically analyzed between subgroups based on the following prognostic factors: pretreatment carcinoembryonic antigen (CEA) levels, mesorectal fascia (MRF) status, T stage (T1,2 and T3,4), N stage (N0 and N1,2), tumor differentiation grade (poor differentiation, poor-moderate differentiation, moderate differentiation, moderate-well differentiation, well differentiation), and extramural venous invasion. RESULTS The differences of NIC values between MRF-free and MRF-invaded groups (P = 0.042), between T2 and T3-4 stage groups (P = 0.044), between N0 and N+ (N1, 2) groups (P = 0.036), between poor differentiation group and other differentiated groups (P < 0.05)were respectively significant. No significant differences of NIC values existed between CEA level or extramural venous invasion subgroups. For NWC values and tumor sizes, there were no significant differences between subgroups based on the prognostic factors above all. CONCLUSIONS Higher NIC value is associated with a more aggressive tumor character. NIC value may have the potential to become an imaging biomarker of tumor aggressiveness.
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Affiliation(s)
- Yi Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China
| | - Xubin Li
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China.
| | - Xiaoyi Ren
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China
| | - Zhaoxiang Ye
- Department of Radiology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, China.
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Ren XJ. CT and MRI assessment of intestinal blood flow. Shijie Huaren Xiaohua Zazhi 2019; 27:851-856. [DOI: 10.11569/wcjd.v27.i14.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The accuracy of multi-slice computed tomography (CT) in the diagnosis of acute mesenteric ischemia is very high, however, it cannot demonstrate the small embolus of blood vessels and abnormal intestinal blood flow. The intestinal blood flow in chronic mesenteric ischemia decreases whereas there are few morphology changes, which leads to a high misdiagnosis rate of CT and CT angiography. In addition, inflammatory bowel disease, intestinal tumors, and portal hypertension can be diagnosed definitely by conventional CT, but the hemodynamics and microcirculation in these conditions cannot be assessed, which affects the accuracy of clinical staging and the assessment of therapeutic effect. For intestinal diseases, especially mesenteric ischemia, therefore, it is needed not only to make CT morphologic diagnosis but also to further assess the abnormal intestinal blood flow. In recent years, more and more CT and magnetic resonance imaging (MRI)-related new techniques for assessing blood flow have emerged, including CT perfusion, spectral CT imaging, magnetic resonance perfusion imaging, and phase contrast MRI. This paper reviews the clinical application and progress of these techniques for assessing intestinal blood flow.
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Affiliation(s)
- Xiao-Jun Ren
- Department of Radiology, Xidian Group Hospital Affiliated Shaanxi University of Chinese Medicine, Xi'an 710077, Shaanxi Province, China
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Spectral CT Imaging in the Differential Diagnosis of Small Bowel Adenocarcinoma From Primary Small Intestinal Lymphoma. Acad Radiol 2019; 26:878-884. [PMID: 30803898 DOI: 10.1016/j.acra.2018.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/13/2018] [Accepted: 08/14/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the value of dual-energy spectral computed tomography (CT) imaging in the differential diagnosis of small bowel adenocarcinoma (SBA) from primary small intestinal lymphoma (PSIL). MATERIALS AND METHODS We retrospectively analyzed the images of 27 SBA cases and 15 PSIL cases. These patients underwent spectral CT imaging in the arterial phase (AP) and venous phase (VP). CT attenuation values of tumors at different energy levels were measured to generate spectral attenuation curve and to calculate curve slope (λHU). Iodine concentration (IC) in tumors at AP and VP were measured and normalized to that of aorta as normalized iodine concentration (NIC). Independent samples t test was used to analyze the spectral CT parameters; Receiver operating characteristic curves were generated to evaluate the diagnostic efficacy of each parameter. RESULTS There were significant differences between SBA and PSIL in IC (2.09 ± 0.71 vs 1.33 ± 0.15 mg/ml), NIC (0.20 ± 0.06 vs 0.13 ± 0.02) and slope (λHU) (2.78 ± 1.06 vs 1.86 ± 0.30) in AP and (1.86 ± 0.68 vs 1.37 ± 0.18 mg/ml for IC; 0.47 ± 0.13 vs 0.33 ± 0.02 for NIC and 2.00 ± 0.56 vs 1.50 ± 0.26 for λHU) in VP (all p < 0.05). For the CT value measurement, there were significant differences between SBA and PSIL in the 40-60keV energy range (p < 0.05), but not in the 70-140keV range (p > 0.05). Using 1.38 mg/ml as a threshold value for iodine concentration at AP, one could obtain the area-under-curve of 0.93 for receiver operating characteristic study and sensitivity of 94% and specificity of 85% for differentiating SBA from PSIL. The sensitivity and specificity values were significantly higher than the respective values of 62% and 60% with the conventional CT numbers at 70keV. CONCLUSION Quantitative parameters obtained in spectral CT, especially iodine concentration in AP, provide high accuracy for differentiating SBA from PSIL.
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Zhou Z, Liu Y, Meng K, Guan W, He J, Liu S, Zhou Z. Application of spectral CT imaging in evaluating lymph node metastasis in patients with gastric cancers: initial findings. Acta Radiol 2019; 60:415-424. [PMID: 29979106 DOI: 10.1177/0284185118786076] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Traditional computed tomography (CT) can predict the lymph node metastasis of gastric cancers with moderate accuracy; however, investigation of spectral CT imaging in this field is still limited. PURPOSE To explore the application of spectral CT imaging in evaluating lymph node metastasis in patients with gastric cancers. MATERIAL AND METHODS Twenty-four patients with gastric cancers prospectively underwent spectral CT imaging in the arterial phase. The short and long diameters, material concentrations, and CT values were measured and compared between lymph nodes with and without metastasis. The diagnostic performance of the CT index in identifying metastatic lymph nodes was analyzed with receiver operating characteristic (ROC) analysis. RESULTS A total of 102 lymph nodes (77 metastatic, 25 non-metastatic) were detected on spectral CT imaging with the reference of postoperative pathologic exanimation. The short and long diameters, water/fat concentrations, CT value, and ratio between lymph nodes vs. tumors of metastatic lymph nodes were significantly higher than those of non-metastatic ones (all P < 0.05). With a cut-off of 0.785, the CT ratio of lymph node/tumor on 70-keV monochromatic images yielded an accuracy of 81.4% in differentiating lymph nodes with and without metastasis. CONCLUSION Spectral CT imaging detects lymph nodes more clearly, and the CT ratio of lymph node/tumor on 70-keV monochromatic images holds great potential in differentiating lymph nodes with and without metastasis, which is more accurate than size measurement.
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Affiliation(s)
- Zhuping Zhou
- 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Yu Liu
- 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Kui Meng
- 2 Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Wenxian Guan
- 3 Department of Gastrointestinal Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Jian He
- 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Song Liu
- 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
| | - Zhengyang Zhou
- 1 Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, PR China
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Yang Q, Yu W, Han X. Overexpression of microRNA‑101 causes anti‑tumor effects by targeting CREB1 in colon cancer. Mol Med Rep 2019; 19:3159-3167. [PMID: 30816471 PMCID: PMC6423622 DOI: 10.3892/mmr.2019.9952] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 01/25/2019] [Indexed: 01/01/2023] Open
Abstract
Accumulating evidence has demonstrated that aberrantly expressed microRNAs (miRNAs) are involved in the initiation and progression of numerous types of human cancer. Although a number of miRNAs have been demonstrated to be associated with the diagnosis, progression and prognosis of colon cancer, the function of miRNA‑101 (miR‑101) in colon cancer remains unclear, and the molecular mechanisms underlying the effects of miR‑101 in colon cancer require further investigation. The present study investigated the role of miR‑101 in colon cancer, and the results suggested that miR‑101 expression levels were significantly decreased in colorectal carcinoma tissues and in three types of colorectal cancer cell lines. Furthermore, overexpression of miR‑101 inhibited cell proliferation and migration in HT29 cells. The transcription factor cAMP responsive element binding protein 1 (CREB1) was identified to be a direct target of miR‑101 using a luciferase reporter assay, reverse transcription‑quantitative polymerase chain reaction analysis and western blot assay. miR‑101 overexpression in tumor xenografts in vivo decreased the expression levels of proliferating cell nuclear antigen and CREB1, and suppressed tumor growth. The present results suggested that miR‑101 may serve a role in colon cancer by directly targeting CREB1. Collectively, the present study may contribute to the development of improved diagnosis and prognostics for colon cancer.
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Affiliation(s)
- Qinglin Yang
- Department of General Surgery, Yantai Yeda Hospital, Yantai, Shandong 264006, P.R. China
| | - Weijie Yu
- Department of General Surgery, Yantai Yeda Hospital, Yantai, Shandong 264006, P.R. China
| | - Xiaoli Han
- Department of General Surgery, Yantai Yeda Hospital, Yantai, Shandong 264006, P.R. China
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Li R, Li J, Wang X, Liang P, Gao J. Detection of gastric cancer and its histological type based on iodine concentration in spectral CT. Cancer Imaging 2018; 18:42. [PMID: 30413174 PMCID: PMC6230291 DOI: 10.1186/s40644-018-0176-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 10/29/2018] [Indexed: 12/19/2022] Open
Abstract
Background Computed tomography (CT) imaging is the most common imaging modality for the diagnosis and staging of gastric cancer. The aim of this study is was to prospectively explore the ability of quantitative spectral CT parameters in the detection of gastric cancer and its histologic types. Methods A total of 87 gastric adenocarcinoma (43 poorly and 44 well-differentiated) patients and 36 patients with benign gastric wall lesions (25 inflammation and 11 normal), who underwent dual-phase enhanced spectral CT examination, were retrospectively enrolled in this study. Iodine concentration (IC) and normalized iodine concentration (nIC) during arterial phase (AP) and portal venous phase (PP) were measured thrice in each patient by two blinded radiologists. Moreover, intraclass correlation coefficient (ICC) was used to assess the interobserver reproducibility. Differences of IC and nIC values between gastric cancer and benign lesion groups were compared using Mann-Whitney U test. Furthermore, the gender, age, location, thickness and histological types of gastric adenocarcinoma were analyzed by Mann-Whitney U test or Kruskal-Wallis H test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of IC and nIC values, and the optimal cut-off value was calculated with Youden J. Results An excellent interobserver agreement (ICC > 0.6) was achieved for IC. Notably, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in gastric cancer group (Z = 5.870, 3.894, 2.009 and 10.137, respectively; P < 0.05) than those in benign lesion group. Additionally, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in poorly differentiated gastric adenocarcinoma group (Z = 4.118, 5.637, 6.729 and 2.950, respectively; P < 0.005) than those in well-differentiated gastric adenocarcinoma group. There were no statistically significant differences in the values of ICAP, ICPP, nICAP and nICPP between age, gender, tumor thickness and tumor location. Furthermore, the area under the curve (AUC) values of ICAP, nICAP, ICPP and nICPP were 0.745, 0.584, 0.662, and 0.932, respectively, for gastric cancer detection; while 0.756, 0.919, 0.851 and 0.684, respectively, in discriminating poorly differentiated gastric adenocarcinoma. Conclusion IC values exhibited great potential in the preoperative and non-invasive diagnosis of gastric cancer and its histological types. In particular, nICPP is more effective for the identification of gastric cancer, whereas nICAP is more effective in discriminating poorly differentiated gastric adenocarcinoma.
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Affiliation(s)
- Rui Li
- Department of Radiology, the First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052, Henan, China
| | - Jing Li
- Department of Radiology, the Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, No. 127, Dongming Road, Zhengzhou, 450008, Henan, China
| | - Xiaopeng Wang
- Department of Radiology, the First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052, Henan, China
| | - Pan Liang
- Department of Radiology, the First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052, Henan, China
| | - Jianbo Gao
- Department of Radiology, the First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052, Henan, China.
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Yeh BM, Obmann MM, Westphalen AC, Ohliger MA, Yee J, Sun Y, Wang ZJ. Dual Energy Computed Tomography Scans of the Bowel: Benefits, Pitfalls, and Future Directions. Radiol Clin North Am 2018; 56:805-819. [PMID: 30119775 DOI: 10.1016/j.rcl.2018.05.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Current computed tomography bowel imaging is challenging given the variable distension, content, and location of the bowel, the different appearance of tumors within and adjacent to bowel, and peristaltic artifacts. Published data remain sparse. Derangements in enhancement may be highlighted, image artifacts reduced, and radiation dose from multiphase scans minimized. This modality is suited for imaging bowel tumor detection and characterization, gastrointestinal bleeding, and bowel inflammation, and ischemia. Experimental results on computed tomography colonography and novel bowel contrast material offer hope for major improvements in bowel interrogation. It is likely to become increasingly valuable for bowel-related disease diagnosis and monitoring.
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Affiliation(s)
- Benjamin M Yeh
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA.
| | - Markus M Obmann
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA
| | - Antonio C Westphalen
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA
| | - Michael A Ohliger
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA
| | - Judy Yee
- Montefiore Department of Radiology, New York, NY, USA; Montefiore Department of Radiology, Montefiore Hospital, 111 East 210th Street, Bronx, NY 10467, USA
| | - Yuxin Sun
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA
| | - Zhen J Wang
- UCSF Department of Radiology, 505 Parnassus Avenue Box 0628, San Francisco, CA 94143-0628, USA
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Morgan DE. The Role of Dual-Energy Computed Tomography in Assessment of Abdominal Oncology and Beyond. Radiol Clin North Am 2018; 56:565-585. [PMID: 29936948 DOI: 10.1016/j.rcl.2018.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The added value and strength of dual energy computed tomography for the evaluation of oncologic patients revolve around the use of lower energy reconstructed images and iodine material density images. Lower keV simulated monoenergetic images optimize soft tissue tumor to nontumoral attenuation differences and increase contrast to noise ratios to improve lesion detection. Iodine material density images or maps are helpful from a qualitative standpoint for image interpretation because they result in improved detection and characterization of tumors and lymph node involvement, and from a quantitative assessment by enabling interrogation of specific properties of tissues to predict and assess therapeutic response.
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Affiliation(s)
- Desiree E Morgan
- Department of Radiology University of Alabama at Birmingham, 619 19th Street South, JTN 456, Birmingham, AL 35249-6830, USA.
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