Quantitative measurement of contrast enhancement of esophageal squamous cell carcinoma on clinical MDCT

Li, Rui; Chen, Tianwu; Wang, Liying; Zhou, Li; Li, Hang; Chen, Xiaoli; Li, Chunping; Zhang, Xiaoming; Xiao, Ruhui

doi:10.4329/wjr.v4.i4.179

Cited by 8 publications

(5 citation statements)

References 29 publications

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“…Some authors claim that there is no need to use the prone position for scanning in clinical practice. 11,[19][20][21] Therefore, in our study, the scanning was performed only in the supine position.…”

Section: Discussionmentioning

confidence: 99%

Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer

Celmer¹,

Międzybrodzki²,

Patyk³

et al. 2023

Adv Clin Exp Med

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Background. The esophageal cancer treatment strategy depends on the tumor stage according to the tumor, node and metastasis (TNM) classification. One of the methods recommended for esophageal cancer assessment is computed tomography (CT). The CT imaging is especially important for patients with contraindications for gastroscopy, which is the primary method used for assessing esophageal diseases.Objectives. The aim of this retrospective study was to evaluate the inter-rater reliability of low-dose hydro-CT with a sinogram-affirmed iterative reconstruction algorithm (SAFIRE) used for the staging of esophageal cancer by 2 independent radiologists. We also evaluated the application of this method for the diagnosis of esophageal cancer. Materials and methods.Low-dose hydro-CT was performed in 65 patients, and the raw data were reconstructed with SAFIRE. Obtained images were retrospectively interpreted by 2 independent and experienced radiologists. Histopathological results were used as the reference standard. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in the diagnosis of esophageal cancer were calculated for hydro-CT. The examination of the inter-rater reliability level in the assessment of the esophageal cancer stage in the TNM classification was performed by calculating Cohen's kappa coefficient (κ) with square weights and standard errors (SEs) for kappa. Independence tests were also performed (Fisher's exact test -two-tailed, and Pearson's χ 2 test).Results. For the diagnosis of esophageal cancer with hydro-CT, a sensitivity of 93%, a specificity of 100%, a PPV of 100%, and a NPV of 88% were observed. In the statistical analyses for the T, N and M stages, κ values greater than 0.90 and significance levels of p < 0.001 were obtained.Conclusions. Hydro-CT using low-dose techniques may be a valuable diagnostic method for staging and diagnosis of esophageal cancer, especially in patients with contraindications for invasive procedures.

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Section: Discussionmentioning

confidence: 99%

Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer

Celmer¹,

Międzybrodzki²,

Patyk³

et al. 2023

Adv Clin Exp Med

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“…On the other hand, this may suggest that LVI occurs when tumor cells infiltrate and destroy the vascular and/or lymphatic structures to form vascular cancer thrombi. Furthermore, tumor angiogenesis is characterized by an increase in the number of tumor blood vessels, and this process will impact CECT [ 28 ]. Due to the individual differences in the degree of enhancement during the arterial phase, the TNR may be a more stable predictor of LVI status.…”

Section: Discussionmentioning

confidence: 99%

Can lymphovascular invasion be predicted by contrast-enhanced CT imaging features in patients with esophageal squamous cell carcinoma? A preliminary retrospective study

Yang

Yue

et al. 2022

BMC Med Imaging

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Background To investigate the value of contrast-enhanced CT (CECT)-derived imaging features in predicting lymphovascular invasion (LVI) status in esophageal squamous cell carcinoma (ESCC) patients. Methods One hundred and ninety-seven patients with postoperative pathologically confirmed esophageal squamous cell carcinoma treated in our hospital between January 2017 and January 2019 were enrolled in our study, including fifty-nine patients with LVI and one hundred and thirty-eight patients without LVI. The CECT-derived imaging features of all patients were analyzed. The CECT-derived imaging features were divided into quantitative features and qualitative features. The quantitative features consisted of the CT attenuation value of the tumor (CTVTumor), the CT attenuation value of the normal esophageal wall (CTVNormal), the CT attenuation value ratio of the tumor-to-normal esophageal wall (TNR), the CT attenuation value difference between the tumor and normal esophageal wall (ΔTN), the maximum thickness of the tumor measured by CECT (Thickness), the maximum length of the tumor measured by CECT (Length), and the gross tumor volume measured by CECT (GTV). The qualitative features consisted of an enhancement pattern, tumor margin, enlarged blood supply or drainage vessels to the tumor (EVFDT), and tumor necrosis. For the clinicopathological characteristics and CECT-derived imaging feature analysis, the chi-squared test was used for categorical variables, the Mann–Whitney U test was used for continuous variables with a nonnormal distribution, and the independent sample t-test was used for the continuous variables with a normal distribution. The trend test was used for ordinal variables. The association between LVI status and CECT-derived imaging features was analyzed by univariable logistic analysis, followed by multivariable logistic regression and receiver operating characteristic (ROC) curve analysis. Results The CTVTumor, TNR, ΔTN, Thickness, Length, and GTV in the group with LVI were higher than those in the group without LVI (P < 0.05). A higher proportion of patients with heterogeneous enhancement pattern, irregular tumor margin, EVFDT, and tumor necrosis were present in the group with LVI (P < 0.05). As revealed by the univariable logistic analysis, the CECT-derived imaging features, including CTVTumor, TNR, ΔTN and enhancement pattern, Thickness, Length, GTV, tumor margin, EVFDT, and tumor necrosis were associated with LVI status (P < 0.05). Only the TNR (OR 8.655; 95% CI 2.125–37.776), Thickness (OR 6.531; 95% CI 2.410–20.608), and tumor margin (OR 4.384; 95% CI 2.004–9.717) were independent risk factors for LVI in the multivariable logistic regression analysis. The ROC curve analysis incorporating the above three CECT-derived imaging features showed that the area under the curve obtained by the multivariable logistic regression model was 0.820 (95% CI 0.754–0.885). Conclusion The CECT-derived imaging features, including TNR, Thickness, tumor margin, and their combination, can be used as predictors of LVI status for patients with ESCC.

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“…Radiomics is a potentially valuable approach to extracting valuable data from computational medical images, providing a noninvasive option for assessing tumors and their immune microenvironment 19,20 as an alternative to biopsy. CT imaging is commonly utilized for cancer evaluation, particularly CECT for detecting primary tumors and lymph nodes in esophageal cancer patients 21 …”

Section: Introductionmentioning

confidence: 99%

“…CT imaging is commonly utilized for cancer evaluation, particularly CECT for detecting primary tumors and lymph nodes in esophageal cancer patients. 21 Our previous study 22 investigated using peripheral blood parameters to assess ESCC patient response to anti-PD-1 therapy combined with other treatments. While feasible, utilizing radiomic features from CECT images provides a more precise evaluation method, as they accurately depict tumor size and grayscale changes over time.…”

Section: Introductionmentioning

confidence: 99%

Contrast‐enhanced CT‐based radiomic analysis for determining the response to anti‐programmed death‐1 therapy in esophageal squamous cell carcinoma patients: A pilot study

Yang,

Huang,

Zhang

et al. 2023

Thoracic Cancer

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BackgroundIn view of the fact that radiomics features have been reported as predictors of immunotherapy to various cancers, this study aimed to develop a prediction model to determine the response to anti‐programmed death‐1 (anti‐PD‐1) therapy in esophageal squamous cell carcinoma (ESCC) patients from contrast‐enhanced CT (CECT) radiomics features.MethodsRadiomic analysis of images was performed retrospectively for image samples before and after anti‐PD‐1 treatment, and efficacy analysis was performed for the results of two different time node evaluations. A total of 68 image samples were included in this study. Quantitative radiomic features were extracted from the images, and the least absolute shrinkage and selection operator method was applied to select radiomic features. After obtaining selected features, three classification models were used to establish a radiomics model to predict the ESCC status and efficacy of therapy. A cross‐validation strategy utilizing three folds was employed to train and test the model. Performance evaluation of the model was done using the area under the curve (AUC) of receiver operating characteristic, sensitivity, specificity, and precision metric.ResultsWavelet and area of gray level change (log‐sigma) were the most significant radiomic features for predicting therapy efficacy. Fifteen radiomic features from the whole tumor and peritumoral regions were selected and comprised of the fusion radiomics score. A radiomics classification was developed with AUC of 0.82 and 0.884 in the before and after‐therapy cohorts, respectively.ConclusionsThe combined model incorporating radiomic features and clinical CECT predictors helps to predict the response to anti‐PD‐1therapy in patients with ESCC.

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Quantitative measurement of contrast enhancement of esophageal squamous cell carcinoma on clinical MDCT

Abstract: CECT might be a clinical technique for discriminating ESCC from normal esophagus, and evaluating outcome in the tumors treated with CRT.

Cited by 8 publications

References 29 publications

Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer

Application of low-dose hydro-CT using SAFIRE in the evaluation of esophageal cancer

Can lymphovascular invasion be predicted by contrast-enhanced CT imaging features in patients with esophageal squamous cell carcinoma? A preliminary retrospective study

Contrast‐enhanced CT‐based radiomic analysis for determining the response to anti‐programmed death‐1 therapy in esophageal squamous cell carcinoma patients: A pilot study

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