Development of a dual-energy spectral computed tomography-based nomogram for the preoperative discrimination of histological grade in colorectal adenocarcinoma patients

Abstract

Background: The usefulness of a dual-energy spectral computed tomography (DESCT)-based nomogram in discriminating between histological grades of colorectal adenocarcinoma (CRAC) is unclear. This study aimed to develop such a nomogram and assess its ability to preoperatively discriminate between histological grades in CRAC patients. Methods: Primary tumors monochromatic CT value, iodine concentration (IC) value, and effective atomic number (Eff-Z) in the arterial (AP) and venous phases (VP) were retrospectively compared between patients with high-grade (n=65) and low-grade (n=108) CRAC who underwent preoperative abdominal DESCT.Univariate analysis was used to compare the DESCT parameters and clinical factors between these two patient groups. Statistically significant features in the univariate analysis were included in the multivariate logistic regression model to identify the indicators for building a nomogram that could discriminate between histological grades in CRAC patients. The clinical usefulness of the nomogram and its value for predicting overall survival were statistically evaluated. Results: The logistic regression analysis showed that age, clinical T stage, clinical N stage, and IC values in AP and VP were significant independent predictors for high-grade CRAC. A quantitative nomogram developed based on these predictors showed excellent performance for discriminating between the histological grades, with an area under the curve (AUC) of 0.886 and excellent agreement in the calibration curve. The Kaplan-Meier curve for overall survival showed that our nomogram identified a significant difference between the high-and low-risk groups [hazard ratio (HR), 2.188; 95% CI, 1.072-4.465; P=0.027). Conclusions: This study presents a nomogram that incorporates DESCT parameters and clinical factors and can potentially be used as a clinical tool for individual preoperative prediction of CRAC histological grade.

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

“…Advanced-stage or high-grade CRAC presents increased angiogenesis and abnormal microvascular permeability, leading to higher NIC values. Our results agreed with those of Cao et al and Gong et al, who used rapid kV switching dual-energy CT (Discovery 750 HD, GE) to evaluate the colon cancer differentiation degree (44,45). They showed that the IC and NIC of high-grade colon cancer were significantly higher than that of low-grade colon cancer; Therefore, quantitative parameters of iodine concentration can provide helpful information in distinguishing low-from high-grade colorectal cancer.…”

The Evaluation of Quantitative Parameters of Dual-layer spectral detector CT for Discrimination of Differentiation grade, T Stage, and Lymph Node Metastasis stage of Colorectal Adenocarcinoma

“…The lower the degree of differentiation means the faster the proliferation of tumor cells, the relatively insu cient blood supply of the tumor, more obvious tumor heterogeneity, more necrosis which all cause a decrease in quantitative parameters of SDCT. Our results were consistent of the past studies [7,12,13].…”

“…Colorectal adenocarcinoma (CRAC) is the most common histological type of colorectal cancer [11]. Up to date, there has been a few studies [7,[12][13][14] that reported the application of SDCT imaging in predicting the pathological staging and histological grading of CRAC, the results from these previous studies are not consistent [15][16][17][18] and need more research to con rm. Therefore, the purpose of this study is to explore the diagnostic value of CRAC differentiation grade, T stage, and lymph node metastasis stage based on different spectral parameters, in order to provide new ideas for clinical treatment and prognosis of CRAC.…”

“…Currently, there are few studies on SDCT for CRC, mainly including evaluating the expression of Ki-67 [4]; the application of nomograms in preoperative histological classi cation of CRAC [7]; enhancing the visualization of colorectal lesions [8]; distinguish between intraluminal and extraluminal iodine or calcium [9]; improve CT virtual colonography via electronic cleansing [10].…”

Role of Single-Nucleotide Polymorphisms in Genes Implicated in Capecitabine Pharmacodynamics on the Effectiveness of Adjuvant Therapy in Colorectal Cancer

“…This statement correlates with what was found in our study, where a low histological grade was associated with better survival outcomes among the CRC patients investigated. Existing evidence indicates that low-grade tumors exhibit less aggressive and invasive behavior than high-grade tumors and improved survival outcomes [ 22 , 25 , 26 , 27 , 28 , 29 , 30 ]. However, it is important to mention that other factors, such as tumor stage, patient age, and general health status, have also been recognized as factors that may influence disease prognosis [ 23 , 24 , 31 ].…”