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Feng QX, Zhu ZN, Li Q, Liu XS. Dual-energy CT quantitative parameters to evaluate occult peritoneal metastasis in advanced gastric cancer preoperatively. Abdom Radiol (NY) 2024; 49:3309-3318. [PMID: 38634880 DOI: 10.1007/s00261-024-04303-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 03/14/2024] [Accepted: 03/20/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE To explore whether dual-energy CT (DECT) quantitative parameters could provide analytic value for the diagnosis of patients with occult peritoneal metastasis (OPM) in advanced gastric cancer preoperatively. MATERIALS AND METHODS This retrospective study included 219 patients with advanced gastric cancer and DECT scans. The patient's clinical data and DECT related iodine concentration (IC) parameters and effective atomic number (Zeff) were collated and analyzed among noun-peritoneal metastasis (NPM), OPM and radiologically peritoneal metastasis (RPM) groups. The predictive performance of the DECT parameters was compared with that of the conventional CT features and clinical characteristics through evaluating area under curve of the precision-recall (AUC-PR), F1 score, balanced accuracy, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). RESULTS Borrmann IV type diagnosed on CT and serum tumor indicator CA125 index were statistically different between the NPM and OPM groups. DECT parameters included IC, normalized IC (NIC), and Zeff of PM group were lower than the NPM group. The DECT predictive nomogram combined three independent DECT parameters produced a better diagnostic performance than the conventional CT feature Borrmann IV type and serum CA125 index in AUC-PR with 0.884 vs 0.368 vs 0.189, but similar to the combined indicator which was based on the DECT parameters, the conventional CT feature, and serum CA125 index in AUC-PR with 0.884 vs 0.918. CONCLUSION The lower quantitative NIC, IC ratio, and Zeff on DECT was associated with peritoneal metastasis in advanced gastric cancer and was promising to identify patients with OPM noninvasively.
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Affiliation(s)
- Qiu-Xia Feng
- Department of Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China
| | - Zhen-Ning Zhu
- Department of Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China
| | - Qiong Li
- Department of Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China
| | - Xi-Sheng Liu
- Department of Radiology, The First Affiliated Hospital With Nanjing Medical University, No. 300, Guangzhou Road, Nanjing, 210009, Jiangsu Province, China.
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Song Q, Wang X, Zhu J, Shi H. Diagnostic value of dual-source, dual-energy computed tomography combined with the neutrophil-lymphocyte ratio for discriminating gastric signet ring cell from mixed signet ring cell and non-signet ring cell carcinomas. Abdom Radiol (NY) 2024; 49:2996-3002. [PMID: 38526596 PMCID: PMC11335798 DOI: 10.1007/s00261-024-04286-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 03/26/2024]
Abstract
PURPOSE To explore the diagnostic value of dual-source computed tomography (DSCT) and neutrophil to lymphocyte ratio (NLR) for differentiating gastric signet ring cell carcinoma (SRC) from mixed SRC (mSRC) and non-SRC (nSRC). METHODS This retrospective study included patients with gastric adenocarcinoma who underwent DSCT between August 2019 and June 2021 at our Hospital. The iodine concentration in the venous phase (ICvp), standardized iodine concentration (NICVP), and the slope of the energy spectrum curve (kVP) were extracted from DSCT data. NLR was determined from laboratory results. DSCT (including ICVP, NICVP, and kVP) and combination (including DSCT model and NLR) models were established based on the multinomial logistic regression analysis. The receiver operator characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the diagnostic value. RESULTS A total of 155 patients (SRC [n = 45, aged 61.22 ± 11.4 years], mSRC [n = 60, aged 61.09 ± 12.7 years], and nSRC [n = 50, aged 67.66 ± 8.76 years]) were included. There were significant differences in NLR, ICVP, NICVP, and kVP among the SRC, mSRC, and nSRC groups (all P < 0.001). The AUC of the combination model for SRC vs. mSRC + nSRC was 0.964 (95% CI: 0.923-1.000), with a sensitivity of 98.3% and a specificity of 86.7%, higher than with DSCT (AUC: 0.959, 95% CI: 0.919-0.998, sensitivity: 90.0%, specificity: 89.9%) or NLR (AUC: 0.670, 95% CI: 0.577-0.768, sensitivity: 62.2%, specificity: 61.8%). CONCLUSION DSCT combined with NLR showed high diagnostic efficacy in differentiating SRC from mSRC and nSRC.
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Affiliation(s)
- Qinxia Song
- Department of radiology, Anqing Municipal Hospital, Anqing, 246000, Anhui province, China
| | - Xiangfa Wang
- Department of radiology, Anqing Municipal Hospital, Anqing, 246000, Anhui province, China.
| | - Juan Zhu
- Department of radiology, Anqing Municipal Hospital, Anqing, 246000, Anhui province, China
| | - Hengfeng Shi
- Department of radiology, Anqing Municipal Hospital, Anqing, 246000, Anhui province, China
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Wang H, Sun X, Yang C, Li Z, Jin D, Zhu W, Yu Z. Deficiency of TOP1MT enhances glycolysis through the stimulation of PDK4 expression in gastric cancer. Cancer Metab 2024; 12:2. [PMID: 38200513 PMCID: PMC10777619 DOI: 10.1186/s40170-024-00330-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Abnormal glucose metabolism is one of the determinants of maintaining malignant characteristics of cancer. Targeting cancer metabolism is regarded as a new strategy for cancer treatment. Our previous studies have found that TOP1MT is a crucial gene that inhibits glycolysis and cell metastasis of gastric cancer (GC) cells, but the mechanism of its regulation of glycolysis remains unclear. METHODS Transcriptome sequencing data, clinic-pathologic features of GC from a variety of public databases, and WGCNA were used to identify novel targets of TOP1MT. Immunohistochemical results of 250 patients with GC were used to analyze the relative expression relationship between TOP1MT and PDK4. The function of TOP1MT was investigated by migration assays and sea-horse analysis in vitro. RESULTS We discovered a mitochondrial topoisomerase I, TOP1MT, which correlated with a higher risk of metastasis. Functional experiments revealed that TOP1MT deficiency promotes cell migration and glycolysis through increasing PDK4 expression. Additionally, the stimulating effect of TOP1MT on glycolysis may be effectively reversed by PDK4 inhibitor M77976. CONCLUSIONS In brief, our work demonstrated the critical function of TOP1MT in the regulation of glycolysis by PDK4 in gastric cancer. Inhibiting glycolysis and limiting tumor metastasis in GC may be accomplished by suppressing PDK4.
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Affiliation(s)
- Hongqiang Wang
- Cancer Chemotherapy Center, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China
| | - Xutao Sun
- Department of General Surgery, Zhoushan Hospital, Wenzhou Medical University, No. 739 Dingshen Road, Lincheng New District, Zhoushan, Zhejiang, 316021, China
| | - Chen Yang
- Department of General Surgery, Zhoushan Hospital, Wenzhou Medical University, No. 739 Dingshen Road, Lincheng New District, Zhoushan, Zhejiang, 316021, China
| | - Ziqi Li
- The Laboratory of Cytobiology and Molecular Biology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China
| | - Danwen Jin
- Department of Pathology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China
| | - Wenwen Zhu
- Cancer Chemotherapy Center, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China
| | - Ze Yu
- Department of General Surgery, Zhoushan Hospital, Wenzhou Medical University, No. 739 Dingshen Road, Lincheng New District, Zhoushan, Zhejiang, 316021, China.
- The Laboratory of Cytobiology and Molecular Biology, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, China.
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Du M, Wang X, Zhuang S, Lou K, Li G, Xie X, Wang M, Zang H, Wang M, Shen W. Quantitative parameters in novel spectral computed tomography for assessing gastric cancer and cell proliferation. Eur J Radiol 2023; 167:111052. [PMID: 37643557 DOI: 10.1016/j.ejrad.2023.111052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVES To investigate the diagnostic ability of novel spectral CT-derived parameters for gastric cancer histological types and Ki-67 expression. METHODS A total of 72 patients with histologically proven gastric cancer (GC) were retrospectively included in this study. All patients underwent dual-phase enhanced abdominal spectral CT. The arterial (AP) and venous phase (VP) slope of the spectral curve (λHU), iodine concentration (IC), normalized IC (NIC), effective atomic number (Zeff) and iodine-no-water concentration were retrospectively compared between patients with low and high Ki-67 expression levels and with different histological types in GC patients. The ROI was outlined independently by two senior physicians, and the average of three measurements at the largest level was taken. In addition, interobserver reproducibility was assessed by Bland-Altman analysis. Correlations between quantitative parameters and Ki-67 expression levels were assessed by Spearman's correlation coefficients. RESULTS The values between the mucinous group and nonmucinous carcinoma group were significantly different in both phases. The IC, NIC, and iodine-no-water concentration in the VP were significantly different among the Ki-67_L, Ki-67_M, and Ki-67_H groups. Spearman rank correlation analysis demonstrated a positive correlation between Ki-67 expression levels and IC, NIC, and iodine-no-water concentration in the VP, with correlation coefficients of 0.304, 0.424, and 0.322, respectively. CONCLUSION Quantitative spectral parameters can discriminate between low and high Ki-67 expression and different histological types in GC. The NIC, IC and iodine-no-water concentration can be useful parameters for evaluating of Ki-67 expression levels.
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Affiliation(s)
- Mei Du
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Xiao Wang
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Shuhao Zhuang
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Kexin Lou
- Department of Pathology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Gang Li
- Department of General Surgery, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Xiaodong Xie
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Mengru Wang
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Hui Zang
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China
| | - Meiqin Wang
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China.
| | - Wenrong Shen
- Department of Radiology, The Affiliated Cancer Hospital of Nanjing Medical University & Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China.
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Wang Y, Tian W, Tian S, He L, Xia J, Zhang J. Spectral CT - a new supplementary method for preoperative assessment of pathological grades of esophageal squamous cell carcinoma. BMC Med Imaging 2023; 23:110. [PMID: 37612644 PMCID: PMC10464448 DOI: 10.1186/s12880-023-01068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/31/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Spectral CT imaging parameters have been reported to be useful in the differentiation of pathological grades in different malignancies. This study aims to investigate the value of spectral CT in the quantitative assessment of esophageal squamous cell carcinoma (ESCC) with different degrees of differentiation. METHODS There were 191 patients with proven ESCC who underwent enhanced spectral CT from June 2018 to March 2020 retrospectively enrolled. These patients were divided into three groups based on pathological results: well differentiated ESCC, moderately differentiated ESCC, and poorly differentiated ESCC. Virtual monoenergetic 40 keV-equivalent image (VMI40keV), iodine concentration (IC), water concentration (WC), effective atomic number (Eff-Z), and the slope of the spectral curve(λHU) of the arterial phase (AP) and venous phase (VP) were measured or calculated. The quantitative parameters of the three groups were compared by using one-way ANOVA and pairwise comparisons were performed with LSD. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of these parameters in poorly differentiated groups and non-poorly differentiated groups. RESULTS There were significant differences in VMI40keV, IC, Eff-Z, and λHU in AP and VP among the three groups (all p < 0.05) except for WC (p > 0.05). The VMI40keV, IC, Eff-Z, and λHU in the poorly differentiated group were significantly higher than those in the other groups both in AP and VP (all p < 0.05). In the ROC analysis, IC performed the best in the identification of the poorly differentiated group and non-poorly differentiated group in VP (AUC = 0.729, Sensitivity = 0.829, and Specificity = 0.569 under the threshold of 21.08 mg/ml). CONCLUSIONS Quantitative parameters of spectral CT could offer supplemental information for the preoperative differential diagnosis of ESCC with different degrees of differentiation.
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Affiliation(s)
- Yi Wang
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China
| | - Weizhong Tian
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China
| | - Shuangfeng Tian
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China
| | - Liang He
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China
| | - Jianguo Xia
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China.
| | - Ji Zhang
- Department of Radiology, Taizhou People's Hospital, NO.366 Taihu Road, Yiyaogaoxin District, Taizhou, 225300, Jiangsu, China.
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He Y, Qi X, Luo X, Wang W, Yang H, Xu M, Wu X, Fan W. The clinical value of dual-energy CT imaging in preoperative evaluation of pathological types of gastric cancer. Technol Health Care 2023; 31:1799-1808. [PMID: 36970925 DOI: 10.3233/thc-220664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND Gastric cancer (GC) is the fifth most common cancer worldwide and the third leading cause of cancer death. Due to the low rate of early diagnosis, most patients are already in the advanced stage and lose the chance of radical surgery. OBJECTIVE To investigate the clinical value of computed tomography (CT) dual-energy imaging in preoperative evaluation of pathological types of gastric cancer patients. METHODS 121 patients with gastric cancer were selected. Dual-energy CT imaging was performed on the patients. The CT values of virtual noncontrast (VNC) images and iodine concentration of the lesion were measured, and the standardized iodine concentration ratio was calculated. The iodine concentration, iodine concentration ratio and CT values of VNC images of different pathological types were analyzed and compared. RESULTS The iodine concentration and iodine concentration ratio of gastric mucinous carcinoma patients in venous phase and parenchymal phase were lower than those of gastric non-mucinous carcinoma patients, and the differences were statistically significant (P< 0.05). The iodine concentration and iodine concentration ratio of patients with mucinous adenocarcinoma in venous phase and parenchymal phase were lower than those of patients with choriocarcinoma, and the differences were statistically significant (P< 0.05). The iodine concentration and iodine concentration ratio of middle and high differentiated adenocarcinoma patients in venous phase and parenchymal phase were lower than those of low differentiated adenocarcinoma patients, and the differences were statistically significant (P< 0.05). However, there was no significant difference in CT values of VNC images among venous, arterial, and parenchymal phases in all pathological types of gastric cancer patients (P> 0.05). CONCLUSION Dual-energy CT imaging plays an important role in the preoperative evaluation of patients with gastric cancer. The pathological types of gastric cancer are different, and the iodine concentration will change accordingly. Dual-energy CT imaging can effectively evaluate the pathological types of gastric cancer and has high clinical application value.
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Affiliation(s)
- Yongsheng He
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Xuan Qi
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Xiao Luo
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Wuling Wang
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Hongkai Yang
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Min Xu
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Xuanyuan Wu
- Department of Radiology, Maanshan People's Hospital, Maanshan, Anhui, China
| | - Wenjie Fan
- School of Graduate, Wannan Medical College, Wuhu, Anhui, China
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Li Y, Younis MH, Wang H, Zhang J, Cai W, Ni D. Spectral computed tomography with inorganic nanomaterials: State-of-the-art. Adv Drug Deliv Rev 2022; 189:114524. [PMID: 36058350 PMCID: PMC9664656 DOI: 10.1016/j.addr.2022.114524] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 08/09/2022] [Accepted: 08/27/2022] [Indexed: 01/24/2023]
Abstract
Recently, spectral computed tomography (CT) technology has received great interest in the field of radiology. Spectral CT imaging utilizes the distinct, energy-dependent X-ray absorption properties of substances in order to provide additional imaging information. Dual-energy CT and multi-energy CT (Spectral CT) are capable of constructing monochromatic energy images, material separation images, energy spectrum curves, constructing effective atomic number maps, and more. However, poor contrast, due to neighboring X-ray attenuation of organs and tissues, is still a challenge to spectral CT. Hence, contrast agents (CAs) are applied for better differentiation of a given region of interest (ROI). Currently, many different kinds of inorganic nanoparticulate CAs for spectral CT have been developed due to the limitations of clinical iodine (I)-based contrast media, leading to the conclusion that inorganic nanomedicine applied to spectral CT will be a powerful collaboration both in basic research and in clinics. In this review, the underlying principles and types of spectral CT techniques are discussed, and some evolving clinical diagnosis applications of spectral CT techniques are introduced. In particular, recent developments in inorganic CAs used for spectral CT are summarized. Finally, the challenges and future developments of inorganic nanomedicine in spectral CT are briefly discussed.
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Affiliation(s)
- Yuhan Li
- School of Medicine, Shanghai University, No. 99 Shangda Rd, Shanghai 200444, PR China
| | - Muhsin H Younis
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, WI 53705, United States
| | - Han Wang
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Rd, Shanghai 200025, PR China
| | - Jian Zhang
- School of Medicine, Shanghai University, No. 99 Shangda Rd, Shanghai 200444, PR China; Shanghai Universal Medical Imaging Diagnostic Center, Bldg 8, No. 406 Guilin Rd, Shanghai 200233, PR China.
| | - Weibo Cai
- Departments of Radiology and Medical Physics, University of Wisconsin-Madison, WI 53705, United States.
| | - Dalong Ni
- Department of Orthopaedics, Shanghai Key Laboratory for Prevention and Treatment of Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Rd, Shanghai 200025, PR China.
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