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Japanese Journal of Radiology

06-05-2024 | Rectal Cancer | Original Article

Spectral CT in the evaluation of perineural invasion status in rectal cancer

Authors: Wenzheng Lu, Xiaoying Tan, Yanqi Zhong, Peng Wang, Yuxi Ge, Heng Zhang, Shudong Hu

Published in: Japanese Journal of Radiology

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Abstract

Purpose

To investigate whether preoperative spectral CT quantitative parameters can assess perineural invasion (PNI) status in rectal cancer.

Methods

Sixty-two patients diagnosed with rectal cancer who underwent preoperative spectral CT were retrospectively enrolled and divided into positive and negative PNI groups according to histopathologic results. The CT attenuation value (HU) of virtual monochromatic images (40–70 keV), spectral curve slope (K(HU)), effective atomic number (Zeff), and iodine concentration (IC) from spectral CT were compared between these two groups using t test or rank sum test. A nomogram was established by incorporating the independent predictors to assess the overall diagnostic efficacy. The area under the ROC curves (AUCs) were compared using the DeLong test.

Results

The preoperative spectral CT parameters (40–70 keV attenuation, K(HU), Zeff, and IC) were significantly higher in the PNI-positive group compared to the PNI-negative group (all p < 0.05). The highest predictive efficiency of PNI was observed at 40 keV attenuation, with an area under the curve (AUC), sensitivity, specificity, and accuracy of 0.847, 81.8%, 72.5%, and 75.8%, respectively. Binary logistic regression demonstrated that the clinical feature (cN stage) and 40 keV attenuation were independent predictors of PNI status. The nomogram incorporating these two predictors (cN stage and 40 keV attenuation) exhibited the best evaluation efficacy, with an AUC, sensitivity, specificity, and accuracy of 0.885, 86.4%, 77.5%, and 80.6%.

Conclusion

Spectral CT quantitative parameters proved valuable in the preoperative assessment of PNI status in rectal cancer patients. The combination of spectral CT parameters and clinical features could further enhance the diagnostic efficiency.
Appendix
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Metadata
Title
Spectral CT in the evaluation of perineural invasion status in rectal cancer
Authors
Wenzheng Lu
Xiaoying Tan
Yanqi Zhong
Peng Wang
Yuxi Ge
Heng Zhang
Shudong Hu
Publication date
06-05-2024
Publisher
Springer Nature Singapore
Published in
Japanese Journal of Radiology
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-024-01575-7