Gastrointestinal stromal tumor risk classification: spectral CT quantitative parameters

Zhang, Xueling; Bai, Liangcai; Wang, Dan; Huang, Xiaoyu; Wei, Jinyan; Zhang, Wenjuan; Zhang, Zhuoli; Zhang, Junlin

doi:10.1007/s00261-019-01973-w

Cited by 22 publications

(25 citation statements)

References 15 publications

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“…Moreover, DESCT has been widely used in clinical practice to identify and malignant lymph nodes, evaluate the response to neoadjuvant treatment, and evaluate microsatellite instability status in patients with CRC (11)(12)(13)(14). Previously published studies have also demonstrated the value of energy spectrum CT in other abdominal tumors, including pathological grading of clear cell renal cell carcinoma (15), differential diagnosis of chromophobe renal cell carcinoma and papillary renal cell carcinoma (16), risk classification of gastrointestinal stromal tumor (17), distinguishing between gastric schwannomas and gastrointestinal stromal tumors (18), and identifying liver cancer and hepatic focal nodular hyperplasia (19). Nomograms have been widely used to quantify the risk factors of CRC biological characteristics (20)(21)(22).…”

Section: Introductionmentioning

confidence: 99%

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

Cao¹,

Zhang²,

Bao³

et al. 2021

J Gastrointest Oncol

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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.

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Section: Introductionmentioning

confidence: 99%

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

Cao¹,

Zhang²,

Bao³

et al. 2021

J Gastrointest Oncol

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“…Unlike the studies in the gastric and colorectal group [ 36 , 48 , 49 ], two studies [ 31 , 60 ] suggested that IC/nIC can differentiate between specific cancer subtypes such as squamous cell carcinoma and adenocarcinoma in the gastroesophageal junction, as well as discriminate between small bowel adenocarcinoma and primary small intestine lymphoma. Additionally, Zhang et al [ 32 ] found a significant difference in IC between high- and moderate/low-risk GIST patients based on GIST recurrence risk stratification criteria [ 61 ].…”

Section: Resultsmentioning

confidence: 99%

“…These measurements can be applied in the different scan phases, e.g., arterial (IC-A), venous (IC-V) or delayed phase (IC-D). Multiple studies investigating IQ have included normalized IC (nIC) as an outcome measure [ 30 , 31 , 32 ], which is calculated based on the equation nIC = IC lesion /IC reference (the reference most commonly being the aorta). The main point of including nIC is to reduce technical or physiological variabilities in iodine load within the tissue of interest due to varying cardiac output and phase times.…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Taudorf

Ulriksen

et al. 2020

Diagnostics

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Dual-energy computed tomography (DECT) can estimate tissue vascularity and perfusion via iodine quantification. The aim of this systematic review was to outline current and emerging clinical applications of iodine quantification within the gastrointestinal tract using DECT. The search was conducted with three databases: EMBASE, Pubmed and The Cochrane Library. This identified 449 studies after duplicate removal. From a total of 570 selected studies, 30 studies were enrolled for the systematic review. The studies were categorized into four main topics: gastric tumors (12 studies), colorectal tumors (8 studies), Crohn’s disease (4 studies) and miscellaneous applications (6 studies). Findings included a significant difference in iodine concentration (IC) measurements in perigastric fat between T1–3 vs. T4 stage gastric cancer, poorly and well differentiated gastric and colorectal cancer, responders vs. non-responders following chemo- or chemoradiotherapy treatment among cancer patients, and a positive correlation between IC and Crohn’s disease activity. In conclusion, iodine quantification with DECT may be used preoperatively in cancer imaging as well as for monitoring treatment response. Future studies are warranted to evaluate the capabilities and limitations of DECT in splanchnic flow.

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“…The HU 40keV indicates that the CT value was gauged on 40 keV images, and HU 70keV indicates that the CT value was gauged on 70 keV images. The NIC was calculated as: NIC = IC lesion /IC aorta , where IC lesion and IC aorta are the iodine level of the lesion and the aorta on the same slice, respectively; the iodine concentration in the lesion is normalized to the aortic iodine concentration to minimize the difference between patients 20 .…”

Section: Methodsmentioning

confidence: 99%

Quantitative dual-energy CT for evaluating hepatocellular carcinoma after transarterial chemoembolization

Yue

Jiang

et al. 2021

Sci Rep

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We aimed to investigate the role of the quantitative parameters of dual-energy computed tomography (DECT) in evaluating patients with hepatocellular carcinoma (HCC) treated by transarterial chemoembolization (TACE). We retrospectively identified 80 HCC patients (mean age, 56 years; 61 men) treated by TACE who received contrast-enhanced DECT and were retreated by TACE within 7 days between November 2018 and December 2019. Taking digital subtraction angiography (DSA) and CT images as reference standard, two readers measured and calculated the values of normalized iodine concentration at arterial phase (NICAP), normalized iodine concentration at portal venous phase (NICPP), iodine concentration difference (ICD), arterial iodine fraction (AIF) and slope of the spectral Hounsfield unit curve (λHu) by placing matched regions of interests (ROIs) within the tumor active area (TAA), adjacent normal hepatic parenchyma (ANHP) and tumor necrotic area (TNA). Differences between the parameters were analyzed by the Kruskal–Wallis H test. Receiver operating characteristic analysis of the parameters performance in differentiating the three tissues types was performed. AIF exhibited a good performance in distinguishing TAA (0.93 ± 0.31) and ANHP (0.18 ± 0.14), the areas under the receiver operating characteristic curve (AUC) was 0.989, while the λHu exhibited an excellent performance in distinguishing TAA (3.32 ± 1.24) and TNA (0.29 ± 0.27), with an AUC of 1.000. In conclusion, quantitative DECT can be effectively used to evaluate the tumor viability in HCC patients treated by TACE.

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Gastrointestinal stromal tumor risk classification: spectral CT quantitative parameters

Cited by 22 publications

References 15 publications

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

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

Gastrointestinal Applications of Iodine Quantification Using Dual-Energy CT: A Systematic Review

Quantitative dual-energy CT for evaluating hepatocellular carcinoma after transarterial chemoembolization

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