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Tytuł:
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Low-dose spectral insufflation computed tomography protocol preoperatively optimized for T stage esophageal cancer - preliminary research experience.
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Autorzy:
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Zhou Y; Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Liu D; Department of Gastroenterology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Hou P; Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Zha KJ; Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Wang F; Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Zhou K; Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
He W; Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
Gao JB; Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China. cjr_.
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Źródło:
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World journal of gastroenterology [World J Gastroenterol] 2018 Sep 28; Vol. 24 (36), pp. 4197-4207.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998-
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MeSH Terms:
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Esophageal Neoplasms/*diagnostic imaging
Esophageal Squamous Cell Carcinoma/*diagnostic imaging
Esophagus/*diagnostic imaging
Tomography, X-Ray Computed/*methods
Aged ; Aged, 80 and over ; Contrast Media/administration & dosage ; Diagnosis, Differential ; Esophageal Neoplasms/pathology ; Esophageal Squamous Cell Carcinoma/pathology ; Esophagoscopy ; Esophagus/pathology ; Feasibility Studies ; Female ; Humans ; Image Processing, Computer-Assisted ; Insufflation/adverse effects ; Insufflation/methods ; Male ; Middle Aged ; Neoplasm Staging ; Radiation Dosage ; Sensitivity and Specificity ; Tomography, X-Ray Computed/adverse effects
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References:
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Contributed Indexing:
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Keywords: Esophageal neoplasms; tomography; tumor staging
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Substance Nomenclature:
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0 (Contrast Media)
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Entry Date(s):
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Date Created: 20181002 Date Completed: 20190122 Latest Revision: 20190122
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Update Code:
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20240105
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PubMed Central ID:
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PMC6158477
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DOI:
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10.3748/wjg.v24.i36.4197
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PMID:
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30271084
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Aim: To evaluate the T stage of esophageal squamous cell carcinoma (ESCC) using preoperative low-dose esophageal insufflation computed tomography (EICT).
Methods: One hundred and twenty ESCC patients confirmed by surgery or esophagoscopy were divided into three groups. Groups B and C were injected with 300 mgI/kg contrast medium for automatic spectral imaging assist (GSI assist), while group A underwent a conventional 120 kVp computed tomography (CT) scan with a 450 mgI/kg contrast medium injection. EICT was performed in group C. Group A was reconstructed with filtered back projection, and groups B and C were reconstructed with 50% adaptive statistical iterative reconstruction. The contrast-to-noise ratio of lesion-to-mediastinal adipose tissue and the radiation dose were measured. Specific imaging features were observed, and T stage ESCCs were evaluated.
Results: The sensitivity and accuracy of the T1/2 stage were higher in group C than in groups A and B (sensitivity: 43.75% vs 31.82% and 33.33%; accuracy: 54.29% vs 46.67% and 52.50%, respectively). With regard to the T3 stage, the sensitivity and specificity in group C were higher than those in groups A and B (sensitivity: 56.25% vs 41.17% and 44.44%; specificity: 73.68% vs 67.86% and 63.64%, respectively). The diagnostic sensitivity, specificity and accuracy of the T4 stage were similar among all groups. There were no significant differences in volume CT dose index [(5.91 ± 2.57) mGy vs (3.24 ± 1.20) vs (3.65 ± 1.77) mGy], dose-length product [(167.10 ± 99.08) mGy•cm vs (113.24 ± 54.46) mGy•cm vs (117.98 ± 32.32) mGy•cm] and effective dose [(2.52 ± 1.39) vs (1.63 ± 0.76) vs (1.73 ± 0.44) mSv] among the groups ( P > 0.05). However, groups B and C received similar effective doses but lower iodine loads than group A [(300 vs 450) mgI/kg].
Conclusion: EICT combined with GSI assist allows differential diagnosis between the T1/2 and T3 stages. The ability to differentially diagnose the T3 and T4 stages of medullary ESCC can be improved by quantitatively and qualitatively analyzing the adipose tissue in front of the vertebral body.
Competing Interests: Conflict-of-interest statement: The authors declare no conflicts of interest.
