Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2022; 28(22): 2468-2481
Published online Jun 14, 2022. doi: 10.3748/wjg.v28.i22.2468
Prognostic value of preoperative enhanced computed tomography as a quantitative imaging biomarker in pancreatic cancer
Jian-Feng Gao, Yu Pan, Xian-Chao Lin, Feng-Chun Lu, Ding-Shen Qiu, Jun-Jun Liu, He-Guang Huang
Jian-Feng Gao, Yu Pan, Xian-Chao Lin, Feng-Chun Lu, He-Guang Huang, Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China
Ding-Shen Qiu, Jun-Jun Liu, Department of Radiology, The Hospital of Changle, Fuzhou 350200, Fujian Province, China
Author contributions: All authors contributed to this paper; Gao JF, Pan Y, Lin XC, Lu FC, Qiu DS, Liu JJ, and Huang HG substantially contributed to conception and design of the study, acquisition of data, or analysis and interpretation of data; Gao JF, Lu FC, and Huang HG contributed to drafting the article or making critical revisions related to important intellectual content of the manuscript; Gao JF, Pan Y, Lin XC, Lu FC, Qiu DS, Liu JJ, and Huang HG finally approved the version of the article to be published.
Supported by the Medical Centre of Minimally Invasive Technology of Fujian Province, No. 2017[171], and No. 2017[4]; Joint Funds for the Innovation of Science and Technology, Fujian Province, No. 2017Y9059; and the United Fujian Provincial Health and Education Project for Tackling the Key Research, No. 2019-WJ-07.
Institutional review board statement: The Ethics Committee of Fujian Medical University Union Hospital approved this retrospective study (No. 2020KY0141).
Informed consent statement: Because of the retrospective and anonymous character of this study, the institutional review committee waived the requirement for informed consent.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: He-Guang Huang, MD, Chief Physician, Department of General Surgery, Fujian Medical University Union Hospital, No. 29 Xinquan Road, Fuzhou 350001, Fujian Province, China. Heguanghuang22@163.com
Received: August 3, 2021
Peer-review started: August 3, 2021
First decision: October 2, 2021
Revised: October 31, 2021
Accepted: May 16, 2022
Article in press: May 16, 2022
Published online: June 14, 2022
ARTICLE HIGHLIGHTS
Research background

Computed tomography (CT) is widely used in the diagnosis, staging and treatment of pancreatic tumours. Because being rich in stroma, pancreatic cancer generally shows a low enhancement pattern compared with normal pancreatic tissue.

Research motivation

We want to use preoperative enhanced CT as a quantitative imaging biomarker to accurately predict the prognosis of patients with pancreatic cancer.

Research objectives

To analyse prognostic value of preoperative enhanced CT in pancreatic cancer.

Research methods

Sixty-seven patients with pancreatic ductal adenocarcinoma undergoing pancreatic resection were enrolled retrospectively. All patients underwent preoperative unenhanced and enhanced CT examination, the CT values of which were measured. The ratio of the preoperative CT value increase from the nonenhancement phase to the portal venous phase between pancreatic tumour and normal pancreatic tissue was calculated. The cut-off value of ratios was obtained by the receiver operating characteristic curve of the tumour relative enhancement ratio (TRER), according to which patients were divided into low- and high-enhancement groups. Cox regression was performed for the univariate (enter model) and multivariate analyses (forward LR model). Finally, Spearman rank correlation or chi-square test was used to analyse the correlation between TRER and clinicopathological characteristics.

Research results

TRER is a quantitative index of enhancement CT. This study showed that the prognosis of patients with the TRER ≤ 0.7 was significantly worse. TRER is a simple and effective parameter. Our results demonstrated that patients in the low TRER group were more likely to have higher American Joint Committee on Cancer stage, tumour stage, lymph node stage, and TRER was significantly negatively correlated with tumour size.

Research conclusions

TRER is a quantitative indicator of enhanced CT and can be used to predict postoperative overall survival in pancreatic cancer.

Research perspectives

In the future, we will further study the value of preoperative enhanced CT in predicting the efficacy of chemotherapy.