Utility of dual-layer spectral-detector CT imaging for predicting pathological tumor stages and histologic grades of colorectal adenocarcinoma
Weicui Chen, Yongsong Ye, daochun zhang, Liting Mao, Lei Guo, Hanliang Zhang, Xiaohua Du, Wei‐Wei Deng, Bo Liu, Xian Liu
Abstract
Objectives To assess the utility of Dual-layer spectral-detector CT (DLCT) in predicting the pT stage and histologic grade for colorectal adenocarcinoma (CRAC). Methods A total of 131 patients (mean 62.7 ± 12.9 years; 72 female, 59 male) with pathologically confirmed CRAC (35 pT1-2, 61 pT3, and 35 pT4; 32 high grade and 99 low grade), who received dual-phase DLCT were enrolled in this retrospective study. Normalized iodine concentration (NIC), slope of the spectral HU curve (λHU), and effective atomic number (Eff-Z) were measured for each lesion by two radiologists independently. Intraobserver reliability and interobserver agreement were assessed. The above values were compared between three pT-stage and two histologic-grade groups. The correlation between the pT stages and above values were assessed. Receiver operating characteristic (ROC) curves were calculated to evaluate the diagnostic efficacy. Results Intra-class correlation coefficients were ranged from 0.856 to 0.983 for all measurements. Eff-Z [7.21(0.09) vs 7.31 (0.10) vs 7.35 (0.19)], NIC AP [0.11 (0.05) vs 0.15 (0.08) vs 0.15 (0.08)], NIC VP [0.27 (0.06) vs 0.34 (0.11) vs 0.35 (0.12)], λHU AP [1.20 (0.45) vs 1.93 (1.18) vs 2.37 (0.91)], and λHU VP [2.07 (0.68) vs 2.35 (0.62) vs 3.09 (1.07)] were significantly different among pT stage groups (all P <0.001) and exhibited a positive correlation with pT stages ( r = 0.503, 0.455, 0.394, 0.512, 0.376, respectively, all P <0.001). Eff-Z [7.37 (0.10) vs 7.28 (0.08)], NIC AP [0.20 (0.10) vs 0.13 (0.08)], NIC VP [0.35 (0.07) vs 0.31 (0.11)], and λHU AP [2.59 (1.11) vs 1.63 (0.75)] in the high-grade group were markedly higher than those in the low-grade group (all P <0.05). For discriminating the advanced- from early-stage CARC, the AUCs of Eff-Z, NIC AP , NIC VP , λHU AP , and λHU VP were 0.83, 0.80, 0.79, 0.86, and 0.68, respectively (all P <0.001). For discriminating the high- from low-grade CARC, the AUCs of Eff-Z, NIC AP , NIC VP , and λHU AP were 0.81, 0.81, 0.64, and 0.81, respectively (all P <0.05). Conclusions The quantitative parameters derived from DLCT may provide new markers for assessing pT stages and histologic differentiation in patients with CRAC.