Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 14, 2023; 29(10): 1602-1613
Published online Mar 14, 2023. doi: 10.3748/wjg.v29.i10.1602
Quantitative parameters in novel spectral computed tomography: Assessment of Ki-67 expression in patients with gastric adenocarcinoma
Li-Ting Mao, Wei-Cui Chen, Jian-Ye Lu, Han-Liang Zhang, Yong-Song Ye, Yu Zhang, Bo Liu, Wei-Wei Deng, Xian Liu
Li-Ting Mao, Wei-Cui Chen, Jian-Ye Lu, Han-Liang Zhang, Yong-Song Ye, Bo Liu, Xian Liu, Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Yu Zhang, Department of Pathology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510120, Guangdong Province, China
Wei-Wei Deng, Department of Scientific Research, Clinical & Technical Support, Philips Healthcare China, Shanghai 200040, China
Author contributions: Mao LT, Chen WC and Liu B designed the research; Lu JY, Zhang HL, Ye YS, and Deng WW collected the data; Mao LT and Liu X analyzed the data and wrote the manuscript; and all authors have read and approved the final manuscript.
Institutional review board statement: This retrospective study was approved by Institutional Review Board of our hospital (approval No.AF/04-07.0/10.0).
Informed consent statement: This informed consent was waived by Institutional Review Board of our hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xian Liu, PhD, Professor, Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 111 Dade Road, Yuexiu District, Guangzhou 510120, Guangdong Province, China. liuxian74@hotmail.com
Received: August 29, 2022
Peer-review started: August 29, 2022
First decision: December 12, 2022
Revised: December 23, 2022
Accepted: January 16, 2023
Article in press: January 16, 2023
Published online: March 14, 2023
Processing time: 192 Days and 20.7 Hours
ARTICLE HIGHLIGHTS
Research background

The level of Ki-67 expression is a valuable prognostic factor in gastric cancer. However, the quantitative parameters based on the novel dual-layer spectral detector computed tomography (DLSDCT) in discriminating the Ki-67 expression status are unclear.

Research motivation

The relationship between the Ki-67 expression in gastric carcinoma (GC) and part spectral parameters (including the effective atomic number (Zeff) and the monoenergetic CT attenuation) is unclear.

Research objectives

This study aimed to investigate the diagnostic ability of DLSDCT-derived parameters for Ki-67 expression status in GC.

Research methods

Dual-phase enhanced abdominal CT was performed preoperatively in 108 patients with GC. The monoenergetic CT attenuation value at 40-100 kilo electron volt (kev), the slope of the spectral curve (λHU), iodine concentration (IC), normalized IC (nIC), Zeff and normalized Zeff (nZeff) in the arterial phase (AP) and venous phase (VP) were retrospectively compared between the groups of low and high Ki-67 expression status. The relationship between the spectral parameters and Ki-67 expression status were analyzed, and the diagnostic efficacy of the statistically significant parameters between the two groups was compared.

Research results

The low and high Ki-67 expression groups consisted of 37 and 71 patients respectively. CT40 kev-VP, CT70 kev-VP, CT100 kev-VP, and Zeff-related parameters were significantly higher, but IC-related parameters were lower in the low Ki-67 expression group than in the high Ki-67 expression group. CT40 kev-VP, CT70 kev-VP, CT100 kev-VP, Zeff, and nZeff exhibited negative correlations with Ki-67 status, whereas IC and nIC positively correlated with it. The results of receiver operating characteristic analysis showed that the multi-variable model of spectral parameters performed well in identifying the Ki-67 status [area under the curve (AUC) = 0.967; sensitivity 95.77%; specificity 91.89%]. Nevertheless, the differentiating capabilities of single-variable model were moderate (AUC value from 0.630 to 0.835).

Research conclusions

Zeff and IC may be useful parameters for evaluating the Ki-67 expression in GC.

Research perspectives

The spectral CT images are prospective to provide the pathological information of Ki-67 expression of GC in the future.