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Dual-energy CT quantitative parameters to evaluate occult peritoneal metastasis in advanced gastric cancer preoperatively

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Abstract

Purpose

To explore whether dual-energy CT (DECT) quantitative parameters could provide analytic value for the diagnosis of patients with occult peritoneal metastasis (OPM) in advanced gastric cancer preoperatively.

Materials and methods

This retrospective study included 219 patients with advanced gastric cancer and DECT scans. The patient’s clinical data and DECT related iodine concentration (IC) parameters and effective atomic number (Zeff) were collated and analyzed among noun-peritoneal metastasis (NPM), OPM and radiologically peritoneal metastasis (RPM) groups. The predictive performance of the DECT parameters was compared with that of the conventional CT features and clinical characteristics through evaluating area under curve of the precision-recall (AUC-PR), F1 score, balanced accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results

Borrmann IV type diagnosed on CT and serum tumor indicator CA125 index were statistically different between the NPM and OPM groups. DECT parameters included IC, normalized IC (NIC), and Zeff of PM group were lower than the NPM group. The DECT predictive nomogram combined three independent DECT parameters produced a better diagnostic performance than the conventional CT feature Borrmann IV type and serum CA125 index in AUC-PR with 0.884 vs 0.368 vs 0.189, but similar to the combined indicator which was based on the DECT parameters, the conventional CT feature, and serum CA125 index in AUC-PR with 0.884 vs 0.918.

Conclusion

The lower quantitative NIC, IC ratio, and Zeff on DECT was associated with peritoneal metastasis in advanced gastric cancer and was promising to identify patients with OPM noninvasively.

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Abbreviations

AUC:

Area under curve

DECT:

Dual-energy CT

ESMO:

European Society for Medical Oncology

GC:

Gastric cancer

IC:

Iodine concentration

ICC:

Interclass correlation coefficient

NCCN:

National Comprehensive Cancer Network

NIC:

Normalized iodine concentration

NLR:

Neutrophil to lymphocyte ratio

NPM:

Noun- peritoneal metastasis

NPV:

Negative predictive value

OPM:

Occult peritoneal metastasis

PLR:

Platelet to lymphocyte ratio

PM:

Peritoneal metastasis

PPV:

Positive predictive value

PR:

Precision-recall

RPM:

Radiologically peritoneal metastasis

SMOTE:

Synthetic Minority Oversampling Technique

Z eff :

Effective atomic number

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Acknowledgements

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Funding

This study was supported by a Key Social Development Program for the Ministry of Science and Technology of Jiangsu Province (BE2017772, Xi-sheng Liu).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China

    Qiu-xia Feng, Zhen-ning Zhu, Qiong Li & Xi-sheng Liu

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Contributions

Conceptualization: Xi-sheng Liu; Data curation: Qiu-xia Feng, Zhen-ning Zhu, Qiong Li; Formal analysis: Qiu-xia Feng, Zhen-ning; Funding acquisition: Xi-sheng Liu; Investigation: Qiu-xia Feng, Zhen-ning Zhu, Qiong Li; Methodology: Qiu-xia Feng, Xi-sheng Liu; Project administration: Xi-sheng Liu, Qiu-xia Feng, Zhen-ning Zhu, Qiong Li; Resources: Qiu-xia Feng, Zhen-ning Zhu, Qiong Li; Software: Qiu-xia Feng, Zhen-ning Zhu, Qiong Li; Supervision: Xi-sheng Liu; Validation: Zhen-ning Zhu; Visualization: Qiu-xia Feng; Writing-original draft: Qiu-xia Feng; Writing-review & editing: Xi-sheng Liu.

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Correspondence to Xi-sheng Liu.

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Feng, Qx., Zhu, Zn., Li, Q. et al. Dual-energy CT quantitative parameters to evaluate occult peritoneal metastasis in advanced gastric cancer preoperatively. Abdom Radiol (2024). https://doi.org/10.1007/s00261-024-04303-x

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