Objective: To explore the value of dual-layer spectral detector CT features of surgically resected esophageal cancer in evaluating differentiation and lymphovascular neural invasion, and to provide a basis for the selection of treatment decisions and the evaluation of prognosis.Methods: Preoperative chest spectral CT images were retrospectively evaluated in 47 surgically resected esophageal cancer and spectral CT features were obtained, including 120 kVp polyenergetic image, 40~70 keV virtual monoenergetic image(VMI), iodine density, anhydrous iodine, and effective atomic number maps. One-way analysis of variance was used for assessing the relationship between spectral CT characteristics of different differentiation degrees. Receiver operating characteristic(ROC) curve was used to analyze the effectiveness of spectral CT characteristics in differentiating esophageal cancer with different differentiation levels(low vs. medium-high), lymphovascular and neural invasion. Results: 40~60 keV VMI, iodine density, anhydrous iodine concentration, and effective atomic number values were significantly different among the low, medium, and highly differentiated esophageal cancers(P values were 0.030, 0.033, 0.043, 0.028, 0.025 and 0.028, respectively).Spectral CT parameters had high diagnostic efficiency in identifying poorly differentiated degrees and lymphovascular neural invasion. Among them, the iodine density had the highest AUC(0.775) for distinguishing poorly differentiated tumors, 50 keV VMI had the highest AUC(0.890) for identifying neural invasion, and 60 keV VMI showed the highest AUC (0.804) for identifying concurrent lymphovascular nerve invasion. Conclusion: Spectral CT features of double-detector can be used to evaluate the degree of differentiation and lymphovascular neural invasion of esophageal cancer. The values of iodine density in the diagnosis of low differentiation, 50 keV VMI in the diagnosis of neural invasion and 60 keV VMI in the diagnosis of concurrent lymphovascular neural invasion are the highest. |
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