Lihong Chen, Presenter: Nothing to Disclose

Qing Duan, Abstract Co-Author: Nothing to Disclose

Yunjing Xue MD, Abstract Co-Author: Nothing to Disclose

Bin Sun, Abstract Co-Author: Nothing to Disclose

Jin Wei, Abstract Co-Author: Nothing to Disclose

To assess the clinical application of gemstone spectral CT imaging in evaluating the different differentiation-state of gastric cancers quantitatively based on Iodine concentration.

67 cases of patient (44men, 23women; median age59 years old) suspected of gastric cancer by gastroscopy were underwent triple-phase (after contrast injection ,28s for arterial phase(AP),55s for venous phase(VP),120s for parenchymal phase(PP), respectively) enhanced CT scan (injection rate of 2.5 ml/s and dose of 1.0 ml/kg) using single source dual-energy CT with fast 80/140kVp switch on gemstone spectral imaging（GSI）mode. All data were transmitted to AW4.4 workstation to obtain iodine-based images with GSI Viewer. The iodine concentration(IC) of lesions were measured by placing a certain size （about 2/3of tumor size）region of interest (ROI) on tumors at the iodine-based images in each enhanced phase, and NIC (normalized iodine concentration) was obtained by dividing the iodine concentration of tumor to that of aorta. Data were analyzed statistically by Independent-Samples T Test and results were correlated with the pathological findings.

There were 32 moderate differentiated and 35 poor differentiated adenocarcinoma confirmed pathologically in our research(well differentiated adenocarcinoma was exclude for only 2 cases). The IC of moderate differentiated adenocarcinoma were lower than those of poor differentiated adenocarcinoma, they were 13.88±3.83mg/cc vs14.82±6.68 mg/cc in AP; 18.98±5.26 mg/cc vs23.43±6.49 mg/cc in VP and 18.28±4.47 mg/cc vs22.95±5.51 mg/cc in PP, respectively. The NIC of moderate differentiated adenocarcinoma were also lower than those of poor differentiated adenocarcinoma, they were 0.17±0.07 vs 0.18±0.06 in AP, 0.48±0.15 vs 0.61±0.16 in VP and 0.63±0.15 vs 0.81±0.21 in PP, respectively. There were all significant difference of IC and NIC between this two groups in VP and in PP (all of them P<0.05) whereas no significant difference in AP (P>0.05).

The IC and NIC obtained from spectral CT imaging could be used to differentiate moderate differentiated adenocarcinoma from poor differentiated adenocarcinoma and was helpful to evaluate the differentiation-state of gastric cancers.

Differential diagnosis of differentiation degree for gastric carcinoma is important for survival prognosis and helpful for making the right therapeutic choice.

Chen, L, Duan, Q, Xue, Y, Sun, B, Wei, J, Preliminary Research of Spectral CT Imaging in Evaluating Histodifferentiation of Gastric Cancer Quantitatively.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12032679.html