Combination of single-source dual-energy computed tomography (CT) parameters and extracellular volume fraction for predicting lymphovascular and perineural invasion in colorectal cancer.

IF 2.9 2区 医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Quantitative Imaging in Medicine and Surgery Pub Date : 2024-10-01 Epub Date: 2024-09-26 DOI:10.21037/qims-24-76
Yuting Zhang, Yurong Wen, Shenglin Li, Liangna Deng, Tao Han, Mengyuan Jing, Jianhong Zhao, Junlin Zhou
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Abstract

Background: Lymphovascular invasion (LVI) and perineural invasion (PNI) are important histopathological variables that are directly related to the survival and recurrence of patients with colorectal cancer (CRC). Preoperative prediction of LVI and PNI status in CRC is helpful in selecting patients requiring appropriate adjuvant therapy and evaluating prognosis. This study aimed to investigate the value of combining single-source dual-energy computed tomography (ssDECT)-derived parameters with extracellular volume (ECV) fraction for preoperative evaluation of LVI and PNI in CRC.

Methods: This retrospective study included patients with CRC who underwent contrast-enhanced ssDECT. All diagnoses were confirmed through histopathology, and the patients were classified into positive and negative groups based on the presence of LVI/PNI. Clinical data were collected. In the arterial (AP), venous (VP) and delayed phases (DP), the ssDECT-derived parameters were measured by two radiologists. The measurement consistency was evaluated using intraclass correlation coefficients. Differences between the two groups were analyzed using the t-test, Mann-Whitney U test, or Chi-square test. Binary logistic regression was employed to construct models incorporating multiple parameters. The diagnostic performance of various parameters or models was assessed by analyzing receiver operating characteristic curves.

Results: In total, 118 patients with CRC were included in the study. Serum carcinoembryonic antigen levels, T and N stages, and histological grades differed between the two groups (all P<0.05). The ssDECT-derived parameters in the VP and DP of LVI/PNI-positive group were higher than those of -negative group (all P<0.05). The ECV fraction in the DP of LVI/PNI-positive group was higher than that of -negative group (P=0.001). Discriminating capability analysis demonstrated that the diagnostic efficacies of the DP parameters were superior to those of the VP parameters, and the normalized iodine concentration in the DP exhibited the best performance [area under the curve (AUC): 0.750; 95% confidence interval (CI): 0.648-0.852]. The combination of ECV DP with clinical and ssDECT-derived parameters demonstrated the highest discriminative capability (AUC: 0.857; 95% CI: 0.786-0.928).

Conclusions: ssDECT-derived parameters and ECV fraction may serve as non-invasive tools for predicting the LVI/PNI status in CRC.

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结合单源双能计算机断层扫描(CT)参数和细胞外体积分数预测结直肠癌的淋巴管和神经周围侵犯。
背景:淋巴管侵犯(LVI)和神经周围侵犯(PNI)是重要的组织病理学变量,与结直肠癌(CRC)患者的生存和复发直接相关。术前预测 CRC 的 LVI 和 PNI 状态有助于选择需要适当辅助治疗的患者和评估预后。本研究旨在探讨将单源双能计算机断层扫描(ssDECT)得出的参数与细胞外体积(ECV)分数相结合,用于术前评估 CRC LVI 和 PNI 的价值:这项回顾性研究纳入了接受对比增强ssDECT检查的CRC患者。所有诊断均通过组织病理学确诊,并根据是否存在 LVI/PNI 将患者分为阳性组和阴性组。收集临床数据。在动脉期(AP)、静脉期(VP)和延迟期(DP),由两名放射科医生测量ssDECT衍生参数。使用类内相关系数评估测量的一致性。两组之间的差异采用 t 检验、曼-惠特尼 U 检验或卡方检验进行分析。二元逻辑回归用于构建包含多个参数的模型。通过分析接收者操作特征曲线来评估各种参数或模型的诊断性能:研究共纳入 118 名 CRC 患者。两组患者的血清癌胚抗原水平、T期和N期以及组织学分级存在差异(全部为PC结论:ssDECT衍生参数和ECV分数可作为预测CRC LVI/PNI状态的无创工具。
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来源期刊
Quantitative Imaging in Medicine and Surgery
Quantitative Imaging in Medicine and Surgery Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
4.20
自引率
17.90%
发文量
252
期刊介绍: Information not localized
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