| Objective: To analyze the application value of dual energy CT quantitative parameters in pathological T staging,grading and metastatic lymph node diagnosis of esophageal carcinoma.Materials and Methods: Forty-nine patients with esophageal cancer diagnosed by pathology were collected.All patients underwent dual-source CT dual-energy enhanced scan.The data were imported into Siemens post-processing workstation(Siemens Syngo.Via).The short diameter of lymph nodes,single energy CT value(CT70 ke V),iodine concentration(IC)of 70 ke V and iodine concentration of aorta were measured on iodine base map and single energy image.Standardized iodine concentration(NIC)and slope of energy spectrum curve(K70-100 ke V)were calculated.Based on the final pathological results,the above data were analyzed according to three grouping methods: moderately and poorly differentiated group,T2,T3,T4 group,metastatic and non-metastatic lymph node group.To compare the differences of dual-energy CT parameters among the three groups.T-test,one-way ANOVA and LSD-t test were used in the statistical methods,and the diagnostic value of each parameter in different groups was evaluated by receiver operating characteristic curve.Results:(1)T2,T3,T4 groups: Arterial phase NIC,K70-100 ke V and venous phase NIC,CT70 ke V,K70-100 ke V are not the same(P<0.05).Further comparison between groups showed that there were significant differences in venous phase CT70 ke V and K70-100 ke V between T2 and T4 groups and between T3 and T4 groups(P<0.05).There were significant differences in arterial phase NIC,K70-100 ke V and venous phase NIC between T2 and T4 groups(P<0.05).There was no significant difference in parameters between T2 and T3(p>0.05).(2)metastatic and non-metastatic lymph nodes: A total of 86 lymph nodes were confirmed by pathology and marked on dual energy CT images.the pathological diagnosis showed 33 metastatic lymph nodes and 53 non-metastatic lymph nodes.There were significant difference between arterial phase IC,K70-100 ke V,CT70 ke V and venous phase IC,NIC,K70-100 ke V,CT70 ke V in different lymph node status of esophageal cancer patients(P<0.05)).The short diameter of lymph nodes in the metastatic group was significantly higher than that in the non-metastatic group(P<0.05).ROC curve analysis shows that venous phase CT70 ke V is the most effective in judging lymph node metastasis of esophageal cancer.When the area under the curve is 0.879 and the critical value is 78.005,the sensitivity is 77.4% and the specificity is 87.9%.(3)medium and high differentiation and low differentiation group:The levels of IC,NIC and CT70 ke V in the poorly differentiated group were significantly higher than those in the moderately well differentiated group,and there were significant differences between the two groups(P<0.05).The levels of CT70 ke V and K70-100 ke V in the poorly differentiated group were significantly higher than those in the moderately well differentiated group,and there were significant differences between the two groups(P<0.05).There was no significant difference in other parameters between middle and high differentiation group and low differentiation group(p>0.05).The ROC curve analysis of the dual-energy CT parameters with statistically significant difference between the two groups showed that the arterial IC was the most effective in judging the differentiation degree of esophageal cancer,the area under the curve was 0.773,and when the arterial iodine concentration threshold was 2.445,the sensitivity was 81% and the specificity was 71%.Conclusion:(1)There are differences in the characteristics of dual energy CT parameters corresponding to different T stages of esophageal cancer,which can be helpful for the differentiation of T stages to some extent.(2)The quantitative parameters of dual-energy CT in different degrees of differentiation gradually increased with the decrease of the degree of differentiation,which can effectively reflect the degree of differentiation by quantitative analysis.(3)The quantitative parameters of dual energy CT have high sensitivity and specificity in the diagnosis of metastatic lymph nodes of esophageal carcinoma,which provides quantitative value for the accurate diagnosis of metastatic lymph nodes of esophageal cancer.To sum up,dual energy CT can be used in T staging,grading and quantitative evaluation of metastatic lymph nodes of esophageal cancer,and can provide some reference for clinical treatment and prognosis of esophageal cancer.Objective: To explore the application value of dual energy CT quantitative parameters in evaluating the efficacy of neoadjuvant therapy in patients with esophageal cancer,and to provide a new method for clinical evaluation.Materials and Methods: A total of twenty-five patients with esophageal cancer diagnosed by pathology were included in this study.All patients were treated with neoadjuvant therapy and underwent dual-source CT dual-energy enhanced scan was performed within one month before and after treatment.The data were imported into Siemens post-processing workstation(Siemens Syngo.Via).The 70 ke V single energy CT value(CT70 ke V),iodine concentration(IC)and aortic iodine concentration of the primary tumor in arterial phase and venous phase were measured on iodine map and single energy image.The standardized iodine concentration(NIC)and the slope of energy spectrum curve(K70-100 ke V)were calculated.Paired sample t-test was used to compare the differences of dual-energy CT parameters before and after treatment.The receiver operating characteristic curve was used to analyze the effectiveness of each parameter in evaluating the efficacy of neoadjuvant therapy for esophageal cancer.Results: There were significant differences in IC,CT70 ke V,K70-100 ke V and NIC in arterial phase and venous phase before and after treatment(P<0.05).There was no significant difference in venous phase NIC between the two groups(P>0.05).The results of ROC curve analysis show that the diagnostic efficiency of K70-100 ke V in venous phase is the highest,and the area under the curve is 0.962.When the critical value is 0.59,the sensitivity is 96% and the specificity is 84%.Conclusion: The quantitative parameters of dual energy CT have good clinical value in evaluating the efficacy of neoadjuvant therapy in patients with esophageal cancer,and provide a new method and reference index,which can be used as imaging markers to evaluate the curative effect. |
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