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The value of single-source dual-energy CT imaging for discriminating microsatellite instability from microsatellite stability human colorectal cancer

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To demonstrate the value of single-source dual-energy computed tomography (ssDECT) imaging for discriminating microsatellite instability (MSI) from microsatellite stability (MSS) colorectal cancer (CRC).

Methods

Thirty-eight and seventy-six patients with pathologically proven MSI and MSS CRC, respectively, were retrospectively selected and compared. These patients underwent contrast-enhanced abdominal ssDECT scans before any anti-cancer treatment. Effective atomic number (Eff-Z) in precontrast phase, slope k of spectral HU curve in precontrast (k-P), arterial (k-A), venous (k-V), and delayed phase (k-D), normalized iodine concentration in arterial (NIC-A), venous (NIC-V), and delayed phase (NIC-D), of tumors in two groups were measured by two reviewers. Consistency of measurements was tested by intra-class correlation coefficients (ICC). Mann-Whitney U test or Student’s t test was used to compare above values between MSI and MSS. Multivariate logistic regression was used to analyze multiple parameters. Receiver operating characteristic curves were calculated to assess diagnostic efficacies.

Results

Interobserver agreement was excellent (ICC > 0.80). MSI CRC had significantly lower values in all measurements (NIC-A, V, D; k-P, A, V, D; Eff-Z) than MSS CRC. For discriminating MSI from MSS CRC, the area under curve (AUC) using k-A was the highest (AUC, 0.803; sensitivity, 72.4%; specificity, 76.3%). The multivariate logistic regression (selection method, Enter) with combined ssDECT parameters (NIC-A, NIC-V, NIC-D, Eff-Z, k-P, k-A, k-V, k-D) significantly improved diagnostic capability with AUC of 0.886 (sensitivity, 81.6%; specificity, 81.6%).

Conclusions

The combination of multiple parameters in ssDECT imaging by multivariate logistic regression provides relatively high diagnostic accuracy for discriminating MSI from MSS CRC.

Key Points

• ssDECT generates multiple parameters for discriminating CRC with MSI from MSS.

• ssDECT measurements for MSI CRC were significantly lower than MSS CRC.

• Combination of ssDECT parameters further improves diagnostic capability for differentiation.

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Abbreviations

AUC:

Area under the curve

CRC:

Colorectal cancer

DNA:

Deoxyribonucleic acid

Eff-Z:

Effective atomic number

GSI:

Gemstone Spectral Imaging

IC:

Iodine concentration

ICC:

Intra-class correlation coefficients

IHC:

Immunohistochemistry

MMR:

Mismatch repair

MRI:

Magnetic resonance imaging

MSI:

Microsatellite instability

MSS:

Microsatellite stability

NIC:

Normalized iodine concentration

PCR:

Polymerase chain reaction

PET-CT:

Positron emission tomography/computed tomography

ROI:

Region of interest

ssDECT:

Single-source dual-energy computed tomography

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Funding

This work was supported by the Program for Training Capital Science and Technology Leading Talents (No. Z181100006318003).

Author information

Author notes

  1. Jingjun Wu and Yue Lv contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China

    Jingjun Wu, Yue Lv, Nan Wang, Ying Zhao, Yijun Liu, Anliang Chen & Ailian Liu

  2. Department of Pathology, The First Affiliated Hospital of Dalian Medical University, Xigang district, Zhongshan road, No.222, Dalian, China

    Pengxin Zhang

  3. GE Healthcare, NO.1 Tongji South Road Beijing Economic Technology Development Area, Beijing, China

    Jianying Li, Xin Li, Yan Guo & Tingfan Wu

Authors
  1. Jingjun Wu
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  2. Yue Lv
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  9. Xin Li
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  10. Yan Guo
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  12. Ailian Liu
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Corresponding author

Correspondence to Ailian Liu.

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Guarantor

The scientific guarantor of this publication is Ailian Liu.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

The informed consent was waived by the Institutional Review Board due to its retrospective design.

Ethical approval

This retrospective study was approved by the Institutional Ethics Committee of the First Affiliated Hospital of Dalian Medical University (Dalian, China) and was performed in accordance with the ethical guidelines of the Declaration of Helsinki.

Methodology

• Retrospective

• Observational

• Performed at one institution

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Wu, J., Lv, Y., Wang, N. et al. The value of single-source dual-energy CT imaging for discriminating microsatellite instability from microsatellite stability human colorectal cancer. Eur Radiol 29, 3782–3790 (2019). https://doi.org/10.1007/s00330-019-06144-5

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  • DOI: https://doi.org/10.1007/s00330-019-06144-5

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