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The value of preoperative diagnosis of colorectal adenocarcinoma pathological T staging based on dual-layer spectral-detector computed tomography extracellular volume fraction: a preliminary study

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Abstract

Purpose

To investigate the value of preoperative diagnosis of colorectal adenocarcinoma (CRAC) pathological T staging based on dual-layer spectral-detector computed tomography (DLCT) extracellular volume fraction (ECV) of CRAC lesions.

Methods

We prospectively collected clinical and DLCT imaging data from 165 patients with CRAC who attended two hospitals from June 2022 to April 2023. The enrolled patients were divided into a training group (n = 110, from Hospital 1) and an external validation group (n = 55, from Hospital 2). Measuring and calculating DLCT parameters of lesions, including CT values of 40 and 100 keV virtual mono-energetic images (VMI), iodine concentration (IC) and effective atomic number (Eff-Z) in the arterial phases (AP) and venous phases (VP), and ECV in the delayed phase (DP). The differences in clinical characteristics and DLCT parameters were compared between different pT subgroups. The correlation between DLCT parameters and pT stages were evaluated by Spearman correlation analysis. A multifactorial binary logistic stepwise forward regression analysis was performed to obtain independent influences associated with pT stage. Receiver operating characteristic curves (ROCs) were used to assess diagnostic efficacy and were expressed as area under the curve (AUC).

Results

Each DLCT parameter was higher in pT3 stage tumors than in pT1-2 stage tumors (all P < 0.05). The highest correlation was found between ECV and pT stage (r = 0.637). ECV were independent influences associated with pT stage. ECV had excellent diagnostic efficacy for CRAC pT staging in both the training and external validation groups (AUC = 0.919 and 0.892).

Conclusion

ECV based on DLCT measurement can be used for preoperative noninvasive diagnosis of CRAC pT staging with excellent diagnostic efficacy. It can provide a new imaging marker for the preoperative evaluation of CRAC and help clinicians formulate individualized treatment earlier. However, it needs to be confirmed with a larger sample size.

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Acknowledgements

The authors acknowledge the support of the Key R&D plan of Jiangsu Province (Social Development, BE2021652) and the special project of “Technological Innovation” project of CNNC Medical Industry Co. Ltd (ZHYLTD2021001).

Funding

This project was supported by the Key R&D plan of Jiangsu Province (Social Development, BE2021652) and the special project of “Technological Innovation” project of CNNC Medical Industry Co. Ltd (ZHYLTD2021001).

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Author notes

  1. Qi Sun and Xuelian Bian are co-first authors and contributed equally to this article.

Authors and Affiliations

  1. Department of Radiology, Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, 215004, Jiangsu, China

    Qi Sun, Xuelian Bian, Mi Wang, Hanyun Dong, Guohua Fan & Guangqiang Chen

  2. Department of Radiology, First Affiliated Hospital of Soochow University, No. 899 Pinghai Road, Suzhou, 215004, Jiangsu, China

    Danqi Sun & Yonggang Li

  3. Department of Pathology, Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, 215004, Jiangsu, China

    Xiaoxiao Dai

  4. Department of Radiotherapy, Second Affiliated Hospital of Soochow University, San Xiang Road No. 1055, Suzhou, 215004, Jiangsu, China

    Liyuan Zhang

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  1. Qi Sun
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Correspondence to Guangqiang Chen.

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The authors declare no conflicts of interest.

Ethical approval

The protocol of this prospective study was approved by the ethical review committees of the Second Affiliated Hospital of Soochow University and the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China. Written informed consent was obtained from all patients included in the study, and anonymity was ensured.

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Sun, Q., Bian, X., Sun, D. et al. The value of preoperative diagnosis of colorectal adenocarcinoma pathological T staging based on dual-layer spectral-detector computed tomography extracellular volume fraction: a preliminary study. Jpn J Radiol (2024). https://doi.org/10.1007/s11604-024-01537-z

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  • DOI: https://doi.org/10.1007/s11604-024-01537-z

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