Relationship Between Dual-energy CT Multi-parameters and the Clinical Pathological Characteristics of Nasopharyngeal Carcinoma and the Predictive Value of Chemoradiotherapy Sensitivity

SONG Ran; LIANG Changhua; LI Qiang; JIN Cailing

doi:10.3969/j.issn.1004-437X.2025.12.006

Abstract：Objective To explore the relationship between dual-energy CT(DECT)multi-parameters and the clinical pathological characteristics of nasopharyngeal carcinoma,as well as its predictive value for chemoradiotherapy sensitivity.Methods A total of 102 patients with nasopharyngeal carcinoma confirmed by pathology in the First Affiliated Hospital of Xinxiang Medical College from March 2021 to March 2024 were selected as the research objects,and all received DECT examination and concurrent chemoradiotherapy.The quantitative parameters of DECT[iodine concentration(IC),nornalized iodine concentration(NIC),and the slope of 40-70 keV energy spectrum curve(K40-70 keV)]in cancer tissues with different clinicopathological characteristics were compared.At 50 Gy of radiotherapy,3 cases fell off,and a total of 99 cases entered the sensitivity analysis of chemoradiotherapy.According to the tumor regression rate,they were divided into sensitive group and resistant group.The quantitative parameters of DECT in two groups were compared.The correlation between quantitative parameters of DECT and clinicopathological characteristics of nasopharyngeal carcinoma and chemoradiotherapy sensitivity was analyzed by Spearman correlation coefficient.Receiver operating characteristic(ROC)curve was used to analyze the value of quantitative parameters of DECT in predicting chemoradiotherapy sensitivity of nasopharyngeal carcinoma.Results The levels of IC,NIC,andK40-70keVin patients with stage Ⅲ-Ⅳ nasopharyngeal carcinoma,lymph node metastasis,and low differentiation were higher than those in patients with stage Ⅰ-Ⅱ,no lymph node metastasis,and high differentiation(P＜0.05).At 50 Gy of radiotherapy,the IC,NIC,and K40-70keV levels in the sensitive group were lower than those in the resistant group,respectively(P＜0.05).Spearman correlation analysis showed that the levels of IC,NIC,and K40～70 keV in the venous phase were positively correlated with tumor staging,lymph node metastasis,and sensitivity to chemoradiotherapy,and negatively correlated with differentiation degree(P＜0.05).ROC analysis showed that the area under the curve(AUC)of IC,NIC,and K40-70keV combined prediction of chemoradiotherapy resistance in the venous phase was 0.907,which was better than the predictive performance of each parameter alone(P＜0.05).Conclusion DECT multi-parameters are correlated with tumor staging,lymph node metastasis,and differentiation degree of nasopharyngeal carcinoma,and have certain predictive value for chemoradiotherapy sensitivity.