AI Article Synopsis
- The study investigates the use of photon counting computed tomography (PCCT) to enhance imaging and assess iodine concentration (IC) in rectal cancer patients undergoing neoadjuvant radiochemotherapy (NARC).
- A total of 41 patients were analyzed, revealing a significant correlation between higher normalized iodine concentration (NIC) values and factors like lymphovascular invasion and treatment response in rectal cancer.
- The findings indicate that a NIC value of 0.36 or higher can effectively predict favorable treatment responses, showcasing high sensitivity (73.9%) and specificity (91.7%).
Article Abstract
Rationale And Objectives: Common computed tomography (CT) investigation plays a limited role in characterizing and assessing the response of rectal cancer (RC) to neoadjuvant radiochemotherapy (NARC). Photon counting computed tomography (PCCT) improves the imaging quality and can provide multiparametric spectral image information including iodine concentration (IC). Our purpose was to analyze associations between IC and histopathology in RC and to evaluate the role of IC in response prediction to NARC.
Materials And Methods: Overall, 41 patients were included into the study, 14 women and 27 men, mean age, 65.5 years. PCCT in a portal venous phase of the abdomen was performed. In every case, a polygonal region of interest (ROI) was manually drawn on iodine maps. Normalized IC (NIC) was also calculated. Tumor stage, grade, lymphovascular invasion, circumferential resection margin, and tumor markers were analyzed. Tumor regression grade (absence/presence of tumor cells) after NARC was analyzed. NIC values in groups were compared to Mann-Whitney-U tests. Sensitivity, specificity, and area under the curve values were calculated. Intraclass correlation coefficient (ICC) was calculated.
Results: ICC was 0.93, 95%CI= (0.88; 0.96). Tumors with lymphovascular invasion showed higher NIC values in comparison to those without (p = 0.04). Tumors with response grade 2-4 showed higher pretreatment NIC values in comparison to lesions with response grade 0-1 (p = 0.01). A NIC value of 0.36 and higher can predict response grade 2-4 (sensitivity, 73.9%; specificity, 91.7%; area under the curve, 0.85).
Conclusion: NIC values showed an excellent interreader agreement in RC. NIC can predict treatment response to NARC.
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| http://dx.doi.org/10.1016/j.acra.2024.02.006 | DOI Listing |
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