Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 11/2023

14-06-2023 | Computed Tomography | Oncology

Quantitative parameters derived from dual-energy computed tomography for the preoperative prediction of early recurrence in patients with esophageal squamous cell carcinoma

Authors: Yan Liu, Fanrong Cheng, Lei Wang, Lihong Du, Hesong Shen, Xiaoxia Wang, Zhen Zeng, Daihong Liu, Junli Tao, Jiaxing Wu, Jiuquan Zhang

Published in: European Radiology | Issue 11/2023

Login to get access

Abstract

Objectives

This study aimed to assess the efficacy of quantitative parameters derived from dual-energy computed tomography (DECT) for the preoperative prediction of early recurrence (ER) in patients with esophageal squamous cell carcinoma (ESCC).

Methods

In total, 78 patients with ESCC who underwent radical esophagectomy and DECT from June 2019 to August 2020 were enrolled in this study. Normalized iodine concentration (NIC) and electron density (Rho) in tumors were measured using arterial and venous phase images, whereas unenhanced images were used to determine the effective atomic number (Zeff). Univariate and multivariate Cox proportional hazards models were used to identify independent risk predictors of ER. Receiver operating characteristic curve analysis was performed using the independent risk predictors. ER-free survival curves were constructed using the Kaplan–Meier method.

Results

NIC in the arterial phase (A-NIC; hazards ratio [HR], 3.91; 95% confidence interval [CI], 1.79–8.56; p = 0.001) and pathological grade (PG; HR, 2.69; 95% CI, 1.32–5.49; p = 0.007) were identified as significant risk predictors of ER. The area under the curve of A-NIC for predicting ER in patients with ESCC was not significantly higher than that of PG (0.72 vs. 0.66, p = 0.441). In a stratified survival analysis, patients with high A-NIC or poorly differentiated ESCC had a higher rate of ER than those with low A-NIC or highly/moderately differentiated ESCC.

Conclusions

A-NIC derived from DECT can be used to noninvasively predict preoperative ER in patients with ESCC, with an efficacy comparable to that of pathological grade.

Clinical relevance statement

Preoperative quantitative measurement of dual-energy CT parameters can predict the early recurrence of esophageal squamous cell carcinoma and serve as an independent prognostic factor to guide clinical designation of personalized treatment.

Key Points

• Normalized iodine concentration in the arterial phase and pathological grade were independent risk predictors of early recurrence in patients with esophageal squamous cell carcinoma.
• Normalized iodine concentration in the arterial phase may be a noninvasive imaging marker for preoperatively predicting early recurrence in patients with esophageal squamous cell carcinoma.
• The efficacy of normalized iodine concentration in the arterial phase derived from dual-energy computed tomography for predicting early recurrence is comparable to that of pathological grade.
Appendix
Available only for authorised users
Literature
1.
Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre L, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424
2.
Chen W, Zheng R, Baade PD et al (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66:115–132
3.
Shah M, Kennedy E, Catenacci D et al (2020) Treatment of locally advanced esophageal carcinoma: ASCO guideline. J Clin Oncol 38:2677–2694
4.
Yang H, Liu H, Chen Y et al (2018) Neoadjuvant chemoradiotherapy followed by surgery versus surgery alone for locally advanced squamous cell carcinoma of the esophagus (NEOCRTEC5010): a phase III multicenter, randomized, open-label clinical trial. J Clin Oncol 36:2796–2803
5.
6.
Allemani C, Matsuda T, Carlo VD et al (2018) Global surveillance of trends in cancer survival 2000-14 (CONCORD-3): analysis of individual records for 37 513 025 patients diagnosed with one of 18 cancers from 322 population-based registries in 71 countries. Lancet 391:1023–1075
7.
Pennathur A, Gibson MK, Jobe BA, Luketich JDJL (2013) Oesophageal carcinoma. Lancet 381:400–412
8.
Kawamoto, Terufumi, Nihei et al (2018) Clinical outcomes and prognostic factors of chemoradiotherapy for postoperative lymph node recurrence of esophageal cancer. Jpn J Clin Oncol 48:259–264
9.
Shapiro J, van Lanschot J, Hulshof M et al (2015) Neoadjuvant chemoradiotherapy plus surgery versus surgery alone for oesophageal or junctional cancer (CROSS): long-term results of a randomised controlled trial. Lancet Oncol 16:1090–1098
10.
Eyck B, van Lanschot J, Hulshof M et al (2021) Ten-year outcome of neoadjuvant chemoradiotherapy plus surgery for esophageal cancer: the randomized controlled CROSS trial. J Clin Oncol 39:1995–2004
11.
Davies A, Pillai A, Sinha P et al (2014) Factors associated with early recurrence and death after esophagectomy for cancer. J Surg Oncol 109:459–464
12.
Zhang Y, Gao J, Zheng A et al (2021) Definition and risk factors of early recurrence based on affecting prognosis of esophageal squamous cell carcinoma patients after radical resection. Transl Oncol 14:101066
13.
Yoshida N, Baba Y, Shigaki H et al (2016) Risk factors of early recurrence within 6?months after esophagectomy following neoadjuvant chemothera py for resectable advanced esophageal squamous cell carcinoma. Int J Clin Oncol 21:1071–1078CrossRefPubMed
14.
Wang S, Chen X, Fan J, Lu L (2016) Prognostic significance of lymphovascular invasion for thoracic esophageal squamous cell carcinoma. Ann Surg Oncol 23:4101–4109
15.
Zhang W, Chen X, Chen W, Zhang H, Zou CL (2018) Nomograms for predicting risk of locoregional recurrence and distant metastases for esophageal cancer patients after radical esophagectomy. BMC Cancer 18:879
16.
Fujiwara Y, Higashida M, Kubota H et al (2021) Perioperative predictive markers for recurrence of esophageal cancer after esophagectomy. Gastrointest Tumors 8:87–95
17.
Godoy M, Bruzzi J, Viswanathan C et al (2013) Multimodality imaging evaluation of esophageal cancer: staging, therapy assessment, and complications. Abdom Imaging 38:974–993
18.
Ott K, Weber W, Lordick F et al (2006) Metabolic imaging predicts response, survival, and recurrence in adenocarcinomas of the esophagogastric junction. J Clin Oncol 24:4692–4698
19.
Mantziari S, Pomoni A, Prior J et al (2020) (18)F- FDG PET/CT-derived parameters predict clinical stage and prognosis of esophageal cancer. BMC Med Imaging 20:7
20.
Coursey C, Nelson R, Boll D et al (2010) Dual-energy multidetector CT: how does it work, what can it tell us, and when can we use it in abdominopelvic imaging? Radiographics 30:1037–1055
21.
Zopfs D, Große Hokamp N, Reimer R et al (2021) Value of spectral detector CT for pretherapeutic, locoregional assessment of esophageal cancer. Eur J Radiol 134:109423
22.
Sun X, Niwa T, Ozawa S, Endo J, Hashimoto J (2022) Detecting lymph node metastasis of esophageal cancer on dual-energy computed tomography. Acta Radiol 63:3–10
23.
Ge X, Yu J, Wang Z et al (2018) Comparative study of dual energy CT iodine imaging and standardized concentrations before and after chemoradiotherapy for esophageal cancer. BMC Cancer 18:1120
24.
Lou F, Sima CS, Adusumilli PS et al (2013) Esophageal cancer recurrence patterns and implications for surveillance. J Thorac Oncol 8:1558–1562
25.
Rice T, Ishwaran H, Ferguson M, Blackstone E, Goldstraw P (2017) Cancer of the esophagus and esophagogastric junction: an eighth edition staging primer. J Thorac Oncol 12:36–42
26.
Jiang T, Zhu A, Sahani DV (2013) Established and novel imaging biomarkers for assessing response to therapy in hepatocellular carcinoma. J Hepatol 58:169–177
27.
Weidner N (1999) Tumour vascularity and proliferation: clear evidence of a close relationship. J Pathol 189:297–299
28.
Igarashi M, Dhar D, Kubota H, Yamamoto A, El-Assal O, Nagasue N (1998) The prognostic significance of microvessel density and thymidine phosphorylase expression in squamous cell carcinoma of the esophagus. Cancer 82:1225–1232
29.
Zhang H, Zou Y, Tian F et al (2022) Dual-energy CT may predict post-operative recurrence in early-stage glottic laryngeal cancer: a novel nomogram and risk stratification system. Eur Radiol 32:1921–1930CrossRefPubMed
30.
Mathy R, Fritz F, Mayer P et al (2021) Iodine concentration and tissue attenuation in dual-energy contrast-enhanced CT as a potential quantitative parameter in early detection of local pancreatic carcinoma recurrence after surgical resection. Eur J Radiol 143:109944
31.
Malik V, Johnston C, Donohoe C et al (2012) (18)F-FDG PET-detected synchronous primary neoplasms in the staging of esophageal cancer: incidence, cost, and impact on management. Clin Nucl Med 37:1152–1158CrossRefPubMed
32.
Tang S, Ou J, Liu J et al (2021) Application of contrast-enhanced CT radiomics in prediction of early recurrence of locally advanced oesophageal squamous cell carcinoma after trimodal therapy. Cancer Imaging 21:38
33.
Lambin P, Rios-Velazquez E, Leijenaar R et al (2012) Radiomics: extracting more information from medical images using advanced feature analysis. Eur J Cancer 48:441–446CrossRefPubMedPubMedCentral
34.
Hamai Y, Emi M, Ibuki Y et al (2019) Early recurrence and cancer death after trimodal therapy for esophageal squamous cell carcinoma. Anticancer Res 39:1433–1440
35.
Zhu Z, Hu Y, Zhao Y, Chen X, Chen L, Chen YT (2011) Early recurrence and death after esophagectomy in patients with esophageal squamous cell carcinoma. Ann Thorac Surg 91:1502–1508
36.
Graser A, Johnson T, Chandarana H, Macari M (2009) Dual energy CT: preliminary observations and potential clinical applications in the abdomen. Eur Radiol 19:13–23
Metadata
Title
Quantitative parameters derived from dual-energy computed tomography for the preoperative prediction of early recurrence in patients with esophageal squamous cell carcinoma
Authors
Yan Liu
Fanrong Cheng
Lei Wang
Lihong Du
Hesong Shen
Xiaoxia Wang
Zhen Zeng
Daihong Liu
Junli Tao
Jiaxing Wu
Jiuquan Zhang
Publication date
14-06-2023
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 11/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-023-09818-3

Other articles of this Issue 11/2023

European Radiology 11/2023 Go to the issue

Cardiac

Financial and clinical outcomes of CT myocardial perfusion imaging and coronary CT angiography-guided versus coronary CT angiography-guided strategy

Breast

Breast density and the likelihood of malignant MRI-detected lesions in women diagnosed with breast cancer

Breast

Deep learning for detection of iso-dense, obscure masses in mammographically dense breasts

Neuro

Aberrant spontaneous brain activity in patients with thyroid-associated ophthalmopathy with and without optic neuropathy: a resting-state functional MRI study

Magnetic Resonance

The role of MRI in the prenatal diagnosis and classification of fetal microtia

Breast

Exploring the added value of pretherapeutic MR descriptors in predicting breast cancer pathologic complete response to neoadjuvant chemotherapy