Skip to main content
Top
Published in: Insights into Imaging 1/2023

Open Access 01-12-2023 | Original Article

Predictive modeling based on tumor spectral CT parameters and clinical features for postoperative complications in patients undergoing colon resection for cancer

Authors: Xiaoying Tan, Xiao Yang, Shudong Hu, Xingbiao Chen, Zongqiong Sun

Published in: Insights into Imaging | Issue 1/2023

Login to get access

Abstract

Background

Colon cancer is a particularly prevalent malignancy that produces postoperative complications (POCs). However, limited imaging modality exists on the accurate diagnosis of POCs. The purpose of this study was therefore to construct a model combining tumor spectral CT parameters and clinical features to predict POCs before surgery in colon cancer.

Methods

This retrospective study included 85 patients who had preoperative abdominal spectral CT scans and underwent radical colon cancer resection at our institution. The patients were divided into two groups based on the absence (no complication/grade I) or presence (grades II–V) of POCs according to the Clavien-Dindo grading system. The visceral fat areas (VFA) of patients were semi-automatically outlined and calculated on L3-level CT images using ImageJ software. Clinical features and tumor spectral CT parameters were statistically compared between the two groups. A combined model of spectral CT parameters and clinical features was established by stepwise regression to predict POCs in colon cancer. The diagnostic performance of the model was evaluated using the receiver operating characteristic (ROC) curve, including area under the curve (AUC), sensitivity, and specificity.

Results

Twenty-seven patients with POCs and 58 patients without POCs were included in this study. MonoE40keV-VP and VFA were independent predictors of POCs. The combined model based on predictors yielded an AUC of 0.84 (95% CI: 0.74–0.91), with a sensitivity of 77.8% and specificity of 87.9%.

Conclusions

The model combining MonoE40keV-VP and VFA can predict POCs before surgery in colon cancer and provide a basis for individualized management plans.

Critical relevance statement

The model combining MonoE40keV-VP and visceral fat area can predict postoperative complications before surgery in colon cancer and provide a basis for individualized management plans.

Key points

• Visceral fat area and MonoE40keV-VP were independent predictors of postoperative complications in colon cancer.
• The combined model yielded a high AUC, sensitivity, and specificity in predicting postoperative complications.
• The combined model was superior to the single visceral fat area or MonoE40keV-VP in predicting postoperative complications.

Graphical Abstract

Literature
1.
go back to reference Baidoun F, Elshiwy K, Elkeraie Y et al (2021) Colorectal cancer epidemiology: recent trends and impact on outcomes. Curr Drug Targets 22(9):998–1009CrossRefPubMed Baidoun F, Elshiwy K, Elkeraie Y et al (2021) Colorectal cancer epidemiology: recent trends and impact on outcomes. Curr Drug Targets 22(9):998–1009CrossRefPubMed
2.
go back to reference Shinji S, Yamada T, Matsuda A et al (2022) Recent advances in the treatment of colorectal cancer: a review. J Nippon Med Sch 89(3):246–254CrossRefPubMed Shinji S, Yamada T, Matsuda A et al (2022) Recent advances in the treatment of colorectal cancer: a review. J Nippon Med Sch 89(3):246–254CrossRefPubMed
3.
go back to reference Beck C, Weber K, Brunner M et al (2020) The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma. Int J Colorectal Dis 35(6):1055–1066CrossRefPubMedPubMedCentral Beck C, Weber K, Brunner M et al (2020) The influence of postoperative complications on long-term prognosis in patients with colorectal carcinoma. Int J Colorectal Dis 35(6):1055–1066CrossRefPubMedPubMedCentral
4.
go back to reference Xiang S, Yang YK, Wang TY, Yang ZT, Lu Y, Liu SL (2022) Development and validation of a nomogram to predict anastomotic leakage in colorectal cancer based on CT body composition. Front Nutr 9:974903CrossRefPubMedPubMedCentral Xiang S, Yang YK, Wang TY, Yang ZT, Lu Y, Liu SL (2022) Development and validation of a nomogram to predict anastomotic leakage in colorectal cancer based on CT body composition. Front Nutr 9:974903CrossRefPubMedPubMedCentral
5.
go back to reference Lee K-C, Chung KC, Chen HH, Cheng KC, Wu KL, Song LC (2022) The impact of obesity on postoperative outcomes in colorectal cancer patients: a retrospective database study. Support Care Cancer 30(3):2151–2161CrossRefPubMed Lee K-C, Chung KC, Chen HH, Cheng KC, Wu KL, Song LC (2022) The impact of obesity on postoperative outcomes in colorectal cancer patients: a retrospective database study. Support Care Cancer 30(3):2151–2161CrossRefPubMed
6.
go back to reference He AQ, Li CQ, Zhang Q, Liu T, Liu J, Liu G (2021) Visceral-to-subcutaneous fat ratio is a potential predictor of postoperative complications in colorectal cancer. Med Sci Monit 27:e930329CrossRefPubMedPubMedCentral He AQ, Li CQ, Zhang Q, Liu T, Liu J, Liu G (2021) Visceral-to-subcutaneous fat ratio is a potential predictor of postoperative complications in colorectal cancer. Med Sci Monit 27:e930329CrossRefPubMedPubMedCentral
7.
go back to reference Heus C, Bakker N, Verduin WM, Doodeman HJ, Houdijk APJ (2019) Impact of body composition on surgical outcome in rectal cancer patients, a retrospective cohort study. World J Surg 43(5):1370–1376CrossRefPubMed Heus C, Bakker N, Verduin WM, Doodeman HJ, Houdijk APJ (2019) Impact of body composition on surgical outcome in rectal cancer patients, a retrospective cohort study. World J Surg 43(5):1370–1376CrossRefPubMed
8.
go back to reference Bian L, Wu D, Chen Y et al (2022) Associations of radiological features of adipose tissues with postoperative complications and overall survival of gastric cancer patients. Eur Radiol 32(12):8569–8578CrossRefPubMed Bian L, Wu D, Chen Y et al (2022) Associations of radiological features of adipose tissues with postoperative complications and overall survival of gastric cancer patients. Eur Radiol 32(12):8569–8578CrossRefPubMed
9.
go back to reference Doyle SL, Bennett AM, Donohoe CL et al (2013) Establishing computed tomography-defined visceral fat area thresholds for use in obesity-related cancer research. Nutr Res 33(3):171–179CrossRefPubMed Doyle SL, Bennett AM, Donohoe CL et al (2013) Establishing computed tomography-defined visceral fat area thresholds for use in obesity-related cancer research. Nutr Res 33(3):171–179CrossRefPubMed
10.
go back to reference He AQ, Li CQ, Zhang Q et al (2021) Visceral-to-subcutaneous fat ratio is a potential predictor of postoperative complications in colorectal cancer. Med Sci Monit 27:e930329CrossRefPubMedPubMedCentral He AQ, Li CQ, Zhang Q et al (2021) Visceral-to-subcutaneous fat ratio is a potential predictor of postoperative complications in colorectal cancer. Med Sci Monit 27:e930329CrossRefPubMedPubMedCentral
11.
go back to reference Lin V, Tsouchnika A, Allakhverdiiev E et al (2022) Training prediction models for individual risk assessment of postoperative complications after surgery for colorectal cancer. Tech Coloproctol 26(8):665–675CrossRefPubMed Lin V, Tsouchnika A, Allakhverdiiev E et al (2022) Training prediction models for individual risk assessment of postoperative complications after surgery for colorectal cancer. Tech Coloproctol 26(8):665–675CrossRefPubMed
12.
go back to reference Sagaert X, Vanstapel A, Verbeek S (2018) Tumor heterogeneity in colorectal cancer: what do we know so far? Pathobiology 85:72–84CrossRefPubMed Sagaert X, Vanstapel A, Verbeek S (2018) Tumor heterogeneity in colorectal cancer: what do we know so far? Pathobiology 85:72–84CrossRefPubMed
13.
go back to reference Sun H, Xu Y, Yang Q, Wang W (2014) Assessment of tumor grade and angiogenesis in colorectal cancer: whole-volume perfusion CT. Acad Radiol 21(6):750–757CrossRefPubMed Sun H, Xu Y, Yang Q, Wang W (2014) Assessment of tumor grade and angiogenesis in colorectal cancer: whole-volume perfusion CT. Acad Radiol 21(6):750–757CrossRefPubMed
14.
go back to reference Sali L, Falchini M, Taddei A, Mascalchi M (2014) Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol 20(14):3795–3803CrossRefPubMedPubMedCentral Sali L, Falchini M, Taddei A, Mascalchi M (2014) Role of preoperative CT colonography in patients with colorectal cancer. World J Gastroenterol 20(14):3795–3803CrossRefPubMedPubMedCentral
15.
go back to reference Bharati A, Rani Mandal S, Gupta AK et al (2022) Non-invasive characterisation of renal stones using dual energy CT: a method to differentiate calcium stones. Phys Med 101:158–164CrossRefPubMed Bharati A, Rani Mandal S, Gupta AK et al (2022) Non-invasive characterisation of renal stones using dual energy CT: a method to differentiate calcium stones. Phys Med 101:158–164CrossRefPubMed
16.
go back to reference Cao Y, Zhang J, Bao H et al (2021) Development of a nomogram combining clinical risk factors and dual-energy spectral CT parameters for the preoperative prediction of lymph node metastasis in patients with colorectal cancer. Front Oncol 11:689176CrossRefPubMedPubMedCentral Cao Y, Zhang J, Bao H et al (2021) Development of a nomogram combining clinical risk factors and dual-energy spectral CT parameters for the preoperative prediction of lymph node metastasis in patients with colorectal cancer. Front Oncol 11:689176CrossRefPubMedPubMedCentral
17.
18.
go back to reference Cao Y, Zhang G, Bao H et al (2021) Development of a dual-energy spectral CT based nomogram for the preoperative discrimination of mutated and wild-type KRAS in patients with colorectal cancer. Clin Imaging 69:205–212CrossRefPubMed Cao Y, Zhang G, Bao H et al (2021) Development of a dual-energy spectral CT based nomogram for the preoperative discrimination of mutated and wild-type KRAS in patients with colorectal cancer. Clin Imaging 69:205–212CrossRefPubMed
19.
go back to reference Huang S, Meng H, Cen R et al (2021) Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients. J Thorac Dis 13:4703–4713CrossRefPubMedPubMedCentral Huang S, Meng H, Cen R et al (2021) Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients. J Thorac Dis 13:4703–4713CrossRefPubMedPubMedCentral
20.
go back to reference Ren T, Zhang W, Li S et al (2022) Combination of clinical and spectral-CT parameters for predicting lymphovascular and perineural invasion in gastric cancer. Diagn Interv Imaging 103(12):584–593CrossRefPubMed Ren T, Zhang W, Li S et al (2022) Combination of clinical and spectral-CT parameters for predicting lymphovascular and perineural invasion in gastric cancer. Diagn Interv Imaging 103(12):584–593CrossRefPubMed
21.
go back to reference Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P (2018) Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg 50(6):256–261CrossRefPubMedPubMedCentral Bolliger M, Kroehnert JA, Molineus F, Kandioler D, Schindl M, Riss P (2018) Experiences with the standardized classification of surgical complications (Clavien-Dindo) in general surgery patients. Eur Surg 50(6):256–261CrossRefPubMedPubMedCentral
22.
go back to reference Bocca G, Mastoridis S, Yeung T, James DRC, Cunningham C (2022) Visceral-to-subcutaneous fat ratio exhibits strongest association with early post-operative outcomes in patients undergoing surgery for advanced rectal cancer. Int J Colorectal Dis 37(8):1893–1900CrossRefPubMedPubMedCentral Bocca G, Mastoridis S, Yeung T, James DRC, Cunningham C (2022) Visceral-to-subcutaneous fat ratio exhibits strongest association with early post-operative outcomes in patients undergoing surgery for advanced rectal cancer. Int J Colorectal Dis 37(8):1893–1900CrossRefPubMedPubMedCentral
23.
go back to reference Amin MB, Edge SB, Greene FL et al (eds) (2017) AJCC Cancer Staging Manual, 8th edn. Springer, New York Amin MB, Edge SB, Greene FL et al (eds) (2017) AJCC Cancer Staging Manual, 8th edn. Springer, New York
24.
go back to reference Vongsuvanh R, George J, Qiao L, van der Poorten D (2013) Visceral adiposity in gastrointestinal and hepatic carcinogenesis. Cancer Lett 330(1):1–10CrossRefPubMed Vongsuvanh R, George J, Qiao L, van der Poorten D (2013) Visceral adiposity in gastrointestinal and hepatic carcinogenesis. Cancer Lett 330(1):1–10CrossRefPubMed
25.
go back to reference Saravana-Bawan B, Goplen M, Alghamdi M, Khadaroo RG (2021) The relationship between visceral obesity and post-operative complications: a meta-analysis. J Surg Res 267:71–81CrossRefPubMed Saravana-Bawan B, Goplen M, Alghamdi M, Khadaroo RG (2021) The relationship between visceral obesity and post-operative complications: a meta-analysis. J Surg Res 267:71–81CrossRefPubMed
26.
go back to reference Verduin WM, Warps A-LK, van den Helder R, Doodeman HJ, Houdijk APJ (2021) Visceral fat and anastomotic leakage after colon cancer resection. Dis Colon Rectum 64(2):163–170CrossRefPubMed Verduin WM, Warps A-LK, van den Helder R, Doodeman HJ, Houdijk APJ (2021) Visceral fat and anastomotic leakage after colon cancer resection. Dis Colon Rectum 64(2):163–170CrossRefPubMed
27.
go back to reference Unamuno X, Gómez-Ambrosi J, Rodríguez A, Becerril S, Frühbeck G, Catalán V (2018) Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Invest 48(9):e12997CrossRefPubMed Unamuno X, Gómez-Ambrosi J, Rodríguez A, Becerril S, Frühbeck G, Catalán V (2018) Adipokine dysregulation and adipose tissue inflammation in human obesity. Eur J Clin Invest 48(9):e12997CrossRefPubMed
29.
go back to reference Sánchez Gómez CA, Tejido Sandoval C, de Vicente BN et al (2022) Surgical complications in a population-based colorectal cancer screening program: Incidence and associated factors. Gastroenterol Hepatol 45(9):660–667CrossRefPubMed Sánchez Gómez CA, Tejido Sandoval C, de Vicente BN et al (2022) Surgical complications in a population-based colorectal cancer screening program: Incidence and associated factors. Gastroenterol Hepatol 45(9):660–667CrossRefPubMed
30.
go back to reference Tchernof A, Després JP (2013) Pathophysiology of human visceral obesity: an update. Physiol Rev 93(1):359–404CrossRefPubMed Tchernof A, Després JP (2013) Pathophysiology of human visceral obesity: an update. Physiol Rev 93(1):359–404CrossRefPubMed
31.
go back to reference Kuritzkes BA, Pappou EP, Kiran RP et al (2018) Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer. Int J Colorectal Dis 33(8):1019–1028CrossRefPubMedPubMedCentral Kuritzkes BA, Pappou EP, Kiran RP et al (2018) Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer. Int J Colorectal Dis 33(8):1019–1028CrossRefPubMedPubMedCentral
32.
go back to reference Drljevic-Nielsen A, Donskov F, Mains JR et al (2022) Prognostic utility of parameters derived from pretreatment dual-layer spectral-detector CT in patients with metastatic renal cell carcinoma. AJR Am J Roentgenol 218(5):867–876CrossRefPubMed Drljevic-Nielsen A, Donskov F, Mains JR et al (2022) Prognostic utility of parameters derived from pretreatment dual-layer spectral-detector CT in patients with metastatic renal cell carcinoma. AJR Am J Roentgenol 218(5):867–876CrossRefPubMed
33.
go back to reference Chen W, Ye Y, Zhang D et al (2022) Utility of dual-layer spectral-detector CT imaging for predicting pathological tumor stages and histologic grades of colorectal adenocarcinoma. Front Oncol 12:1002592CrossRefPubMedPubMedCentral Chen W, Ye Y, Zhang D et al (2022) Utility of dual-layer spectral-detector CT imaging for predicting pathological tumor stages and histologic grades of colorectal adenocarcinoma. Front Oncol 12:1002592CrossRefPubMedPubMedCentral
34.
go back to reference Deng F, Zhou R, Lin C et al (2019) Tumor-secreted dickkopf2 accelerates aerobic glycolysis and promotes angiogenesis in colorectal cancer. Theranostics 9(4):1001–1014CrossRefPubMedPubMedCentral Deng F, Zhou R, Lin C et al (2019) Tumor-secreted dickkopf2 accelerates aerobic glycolysis and promotes angiogenesis in colorectal cancer. Theranostics 9(4):1001–1014CrossRefPubMedPubMedCentral
35.
go back to reference Gao W, Zhang Y, Dou Y et al (2023) Association between extramural vascular invasion and iodine quantification using dual-energy computed tomography of rectal cancer: a preliminary study. Eur J Radiol 158:110618CrossRefPubMed Gao W, Zhang Y, Dou Y et al (2023) Association between extramural vascular invasion and iodine quantification using dual-energy computed tomography of rectal cancer: a preliminary study. Eur J Radiol 158:110618CrossRefPubMed
Metadata
Title
Predictive modeling based on tumor spectral CT parameters and clinical features for postoperative complications in patients undergoing colon resection for cancer
Authors
Xiaoying Tan
Xiao Yang
Shudong Hu
Xingbiao Chen
Zongqiong Sun
Publication date
01-12-2023
Publisher
Springer Vienna
Published in
Insights into Imaging / Issue 1/2023
Electronic ISSN: 1869-4101
DOI
https://doi.org/10.1186/s13244-023-01515-5

Other articles of this Issue 1/2023

Insights into Imaging 1/2023 Go to the issue