Value of Dual-Energy CT in Evaluating Tumor Invasion Characteristics of Gastric Adenocarcinoma Patients with Different Clinical Stages

PENG Xuhan

doi:10.14033/j.cnki.cfmr.2025.29.006

Abstract：Objective:To explore the evaluation value of dual-energy CT(DECT)for the tumor invasion characteristics of patients with gastric adenocarcinoma at different clinical stages.Method:A retrospective analysis was conducted on the data of 106 patients with gastric adenocarcinoma(21 cases in clinical stage Ⅰ,29 cases in stage Ⅱ,and 56 cases in stage Ⅲ)admitted to the First Hospital of Nanping City from July 2023 to July 2024.All patients underwent preoperative DECT scans.Surgical pathological examination included 65 cases of low differentiation and 41 cases of moderate to high differentiation.According to the stratification based on clinical stages,the DECT parameters of patients with different degrees of differentiation were compared,and the receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of DECT for tumor invasion characteristics.Result:Among patients with clinical stage Ⅰ～Ⅱ,the standardized iodine concentration in the venous phase and the slope of the energy spectrum curve in poorly differentiated patients were higher than those in moderately and well differentiated patients,and the difference was statistically significant(P<0.05).Among patients with clinical stage Ⅲ,the standardized iodine concentration in the venous phase of poorly differentiated patients was higher than that of moderately and highly differentiated patients,and the difference was statistically significant(P<0.05).The slopes of the energy spectrum curves in the arterial phase,venous phase,and delayed phase were all higher than those in moderately and highly differentiated patients,and the differences were statistically significant(P<0.05).The ROC results showed that the areas under the low-differentiation curves of patients with clinical stages Ⅰ～Ⅱ predicted by the standardized iodine concentration in the venous phase and the slope of the energy spectrum curve were 0.692 and 0.678,respectively,and the area under the combined prediction curve was 0.757.The AUC of the standardized iodine concentration in the venous phase,the slope of the energy spectrum curve in the arterial phase,venous phase,and delayed phase for predicting hypodifferentiation in patients with clinical stage Ⅲ were 0.662,0.628,0.799,and 0.811,respectively,and the combined prediction AUC was 0.910.Conclusion:DECT has a good predictive value for tumor invasion characteristics in patients with gastric adenocarcinoma at different clinical stages and can be used for preoperative differentiation degree analysis and guidance.