Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China; Department of Radiology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, China.
Department of Radiology, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.
Diagn Interv Radiol. 2022 Sep;28(5):388-395. doi: 10.5152/dir.2022.201007.
PURPOSE We aimed to systematically explore the value of iodine values calculated from dual-energy computed tomography (DECT) as potential prognostic factors for locally advanced gastric cancer (LAGC) patients undergoing neoadjuvant chemotherapy (NAC). METHODS Eighty-five LAGC patients were examined using DECT before and after NAC and were divided into responders and non-responders based on the tumor regression grade (TRG). The iodine values, including portal- and delayed-phase iodine uptake (IU-p and IU-d, mg/ml) and total iodine uptake (TIU-p and TIU-d, mg) were acquired. Correlations between the reduction ratios of iodine values and TRG were analyzed. The diagnostic performance of parameters for differentiating responders from non-responders was calculated. Kaplan-Meier method was used for survival analysis. RESULTS The reduction ratios of total iodine uptake (%△TIU-p and %△TIU-d) were significantly correlated with TRG (p < 0.001). The ypN stage, %△TIU-p and %△TIU-d were significant factors influencing PFS (p < 0.050). A value of %△TIU-d≤62.19% was associated with negative prognosis [relative risk (RR):2.103; P = 0.021], as was ypN stage (RR:4.250; p = 0.003). CONCLUSION Iodine values (especially the TIU) are noninvasive quantitative parameters that are potentially helpful for evaluating the treatment response and survival prognosis of LAGC after NAC. %△TIU-d represents a strong independent prognostic factor, increasing preoperative risk assessment performance.
本研究旨在系统探讨双能 CT（DECT）碘值在预测接受新辅助化疗（NAC）的局部晚期胃癌（LAGC）患者中的潜在价值。
对 85 例 LAGC 患者在 NAC 前后进行 DECT 检查，并根据肿瘤退缩分级（TRG）将其分为反应者和无反应者。获取碘值，包括门静脉期和延迟期碘摄取量（IU-p 和 IU-d，mg/ml）和总碘摄取量（TIU-p 和 TIU-d，mg）。分析碘值的降低率与 TRG 的相关性。计算各参数鉴别反应者和无反应者的诊断性能。采用 Kaplan-Meier 法进行生存分析。
总碘摄取量的降低率（%△TIU-p 和 %△TIU-d）与 TRG 显著相关（p<0.001）。ypN 分期、%△TIU-p 和 %△TIU-d 是影响 PFS 的显著因素（p<0.050）。%△TIU-d≤62.19%与预后不良相关（相对风险 RR：2.103；P=0.021），ypN 分期亦然（RR：4.250；P=0.003）。
碘值（尤其是 TIU）是一种潜在的有助于评估 LAGC 患者 NAC 后治疗反应和生存预后的无创定量参数。%△TIU-d 是一个独立的预后因素，可提高术前风险评估效能。
