AUTHOR=Chen Weicui , Ye Yongsong , Zhang Daochun , Mao Liting , Guo Lei , Zhang Hanliang , Du Xiaohua , Deng Weiwei , Liu Bo , Liu Xian 

TITLE=Utility of dual-layer spectral-detector CT imaging for predicting pathological tumor stages and histologic grades of colorectal adenocarcinoma

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1002592

DOI=10.3389/fonc.2022.1002592

ISSN=2234-943X

ABSTRACT=<sec><title>Objectives</title><p>To assess the utility of Dual-layer spectral-detector CT (DLCT) in predicting the pT stage and histologic grade for colorectal adenocarcinoma (CRAC).</p></sec><sec><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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<sub>AP</sub> [0.11 (0.05) vs 0.15 (0.08) vs 0.15 (0.08)], NIC<sub>VP</sub> [0.27 (0.06) vs 0.34 (0.11) vs 0.35 (0.12)], λHU<sub>AP</sub> [1.20 (0.45) vs 1.93 (1.18) vs 2.37 (0.91)], and λHU<sub>VP</sub> [2.07 (0.68) vs 2.35 (0.62) vs 3.09 (1.07)] were significantly different among pT stage groups (all <italic>P</italic>&lt;0.001) and exhibited a positive correlation with pT stages (<italic>r</italic>= 0.503, 0.455, 0.394, 0.512, 0.376, respectively, all <italic>P</italic>&lt;0.001). Eff-Z [7.37 (0.10) vs 7.28 (0.08)], NIC<sub>AP</sub>[0.20 (0.10) vs 0.13 (0.08)], NIC<sub>VP</sub>[0.35 (0.07) vs 0.31 (0.11)], and λHU<sub>AP</sub> [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 <italic>P</italic>&lt;0.05). For discriminating the advanced- from early-stage CARC, the AUCs of Eff-Z, NIC<sub>AP</sub>, NIC<sub>VP</sub>, λHU<sub>AP</sub>, and λHU<sub>VP</sub> were 0.83, 0.80, 0.79, 0.86, and 0.68, respectively (all <italic>P</italic>&lt;0.001). For discriminating the high- from low-grade CARC, the AUCs of Eff-Z, NIC<sub>AP</sub>, NIC<sub>VP</sub>, and λHU<sub>AP</sub> were 0.81, 0.81, 0.64, and 0.81, respectively (all <italic>P</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>The quantitative parameters derived from DLCT may provide new markers for assessing pT stages and histologic differentiation in patients with CRAC.</p></sec>