Measuring iodine concentration in perigastric adipose tissue with DECT for judgment of serosa status in patients with advanced gastric cancer after NAC

YANG Li; SHI Gao-feng; LI Yong; ZHOU Tao

Journal of China Clinic Medical Imaging ›› 2018, Vol. 29 ›› Issue (4) : 273-276.

YANG Li, SHI Gao-feng, LI Yong, ZHOU Tao

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Abstract

Objective: To explore the value of measuring iodine concentration(IC) in perigastric adipose tissue with dual-energy CT(DECT) for judgment of serosa status after neoadjuvant chemotherapy(NAC). Methods: Thirty-four patients with T4 advanced gastric cancer who underwent DECT before and after treatment were enrolled. According to the postoperative pathologic results, the patients were divided into two groups: the down-staging group(n=10) and the non-down-staging group(n=24). IC(ICPAT) and standardized IC(SICPAT) of perigastric adipose tissue were measured in the two groups, respectively. ROC curve was used to evaluate the capability of SICPAT in detecting serosa invasion. Results: Compared with postoperative pathologic results, the accuracy of judgment of serosa status was 70.59% by conventional CT after NAC. The differences of the changes of ICPAT(△ICPAT) and SICPAT(△SICPAT) between the two groups were statistically significant(P＜0.05). With a △SICPAT threshold of 0.095, area under curve(AUC) was 0.908, the sensitivity, specificity and accuracy for detecting serosa invasion were 90.0%, 83.3% and 85.29%, respectively. Conclusion: The SICPAT in perigastric adipose tissue is an effective indicator to determine the serosa status after NAC and to guide the operation time.

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Stomach neoplasms / Tomography, X-ray computed

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YANG Li, SHI Gao-feng, LI Yong, ZHOU Tao. Measuring iodine concentration in perigastric adipose tissue with DECT for judgment of serosa status in patients with advanced gastric cancer after NAC[J]. Journal of China Clinic Medical Imaging. 2018, 29(4): 273-276

References

[1]Hallinan JT, Venkatesh SK. Gastric carcinoma: imaging diagnosis, staging and assessment of treatment response[J]. Cancer Imaging, 2013, 13(2): 212-227.
[2]Carl-Mcgrath S, Ebert M, Rocken C. Gastric adenocarcinoma: epidemiology, pathology and pathogenesis[J]. Cancer Therapy, 2007, 6(2): 877-894.
[3]Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer[J]. N Engl J Med, 2006, 355(1): 11-20.
[4]Yang L, Shi G, Zhou T, et al. Quantification of the iodine content of perigastric adipose tissue by dual-energy CT: a novel method for preoperative diagnosis of T4-stage gastric cancer[J]. PLoS One, 2015, 10(9): e0136871.
[5]Lee SM, Kim SH, Lee JM, et al. Usefulness of CT volumetry for primary gastric lesions in predicting pathologic response to neoadjuvant chemotherapy in advanced gastric cancer[J]. Abdom Imaging, 2009, 34(4): 430-440.
[6]Beer AJ, Wieder HA, Lordick F, et al. Adenocarcinomas of esophagogastric junction: multi-detector row CT to evaluate early response to neoadjuvant chemotherapy[J]. Radiology, 2006, 239(2): 472-480.
[7]Wieder HA, Beer AJ, Lordick F, et al. Comparison of changes in tumor metabolic activity and tumor size during chemotherapy of adenocarcinomas of the esophagogastric junction[J]. J Nucl Med, 2005, 46(12): 2029-2034.
[8]Becker K, Langer R, Reim D, et al. Significance of histopathological tumor regression after neoadjuvant chemotherapy in gastric adenocarcinomas: a summary of 480 cases[J]. Ann Surg, 2011, 253(5): 934-939.
[9]Yoshikawa T, Tanabe K, Nishikawa K, et al. Accuracy of CT staging of locally advanced gastric cancer after neoadjuvant chemotherapy: cohort evaluation within a randomized phase Ⅱ study[J]. Ann Surg Oncol, 2014, 21(Suppl 3): S385-S389.
[10]Schmid-Bindert G, Henzler T, Chu TQ, et al. Functional imaging of lung cancer using dual energy CT: how does iodine related attenuation correlate with standardized uptake value of 18FDG-PET-CT?[J]. Eur Radiol, 2012, 22(1): 93-103.
[11]Lin XZ, Wu ZY, Tao R, et al. Dual energy spectral CT imaging of insulinoma-value in preoperative diagnosis compared with conventional multi-detector CT[J]. Eur J Radiol, 2012, 81(10): 2487-2494.
[12]Ho LM, Marin D, Neville AM, et al. Characterization of adrenal nodules with dual-energy CT: can virtual unenhanced attenuation values replace true unenhanced attenuation values?[J]. AJR, 2012, 198(4): 840-845.
[13]Boellaard TN, Henneman OD, Streekstra GJ, et al. The feasibility of colorectal cancer detection using dual-energy computed tomography with iodine mapping[J]. Clin Radiol, 2013, 68(8): 799-806.
[14]Ascenti G, Mileto A, Krauss B, et al. Distinguishing enhancing from nonenhancing renal masses with dual-source dual-energy CT: iodine quantification versus standard enhancement measurements[J]. Eur Radiol, 2013, 23(8): 2288-2295.
[15]Dai X, Schlemmer HP, Schmidt B, et al. Quantitative therapy response assessment by volumetric iodine-uptake measurement: initial experience in patients with advanced hepatocellular carcinoma treated with sorafenib[J]. Eur J Radiol, 2013, 82(2): 327-334.
[16]Apfaltrer P, Meyer M, Meier C, et al. Contrast-enhanced dual-energy CT of gastrointestinal stromal tumors: is iodine-related attenuation a potential indicator of tumor response?[J]. Invest Radiol, 2012, 47(1): 65-70.
[17]Tang L, Li ZY, Li ZW, et al. Evaluating the response of gastric carcinomas to neoadjuvant chemotherapy using iodine concentration on spectral CT: a comparison with pathological regression[J]. Clin Radiol, 2015, 70(11): 1198-1204.