Low-dose spectral insufflation computed tomography protocol preoperatively optimized for T stage esophageal cancer-preliminary research experience  

作　　者：Yue Zhou Dan Liu Ping Hou Kai-Ji Zha Feng Wang Kun Zhou Wei He Jian-Bo Gao 

机构地区：[1]Department of Radiology,The First Affiliated Hospital of Zhengzhou University [2]Department of Gastroenterology,The First Affiliated Hospital of Zhengzhou University [3]Department of Oncology,The First Affiliated Hospital of Zhengzhou University [4]Department of Thoracic Surgery,The First Affiliated Hospital of Zhengzhou University

出　　处：《World Journal of Gastroenterology》2018年第36期4197-4207,共11页世界胃肠病学杂志（英文版）

基　　金：Supported by Scientific and Technological Support Plan Projects of China,No.2007BAI05B05;Medical Science and Technology Project of Henan Province,No.201602012

摘　　要：AIM To evaluate the T stage of esophageal squamous cell carcinoma(ESCC) using preoperative low-dose esophageal insufflation computed tomography(EICT).METHODS One hundred and twenty ESCC patients confirmed by surgery or esophagoscopy were divided into three groups. Groups B and C were injected with 300 mgI/kg contrast medium for automatic spectral imaging assist(GSI assist), while group A underwent a conventional 120 kVp computed tomography(CT) scan with a 450 mg I/kg contrast medium injection. EICT was performed in group C. Group A was reconstructed with filtered back projection, and groups B and C were reconstructed with 50% adaptive statistical iterative reconstruction. The contrast-to-noise ratio of lesion-to-mediastinal adipose tissue and the radiation dose were measured. Specific imaging features were observed, and T stage ESCCs were evaluated.RESULTS The sensitivity and accuracy of the T1/2 stage were higher in group C than in groups A and B(sensitivity: 43.75% vs 31.82% and 33.33%; accuracy: 54.29% vs 46.67% and 52.50%, respectively). With regard to the T3 stage, the sensitivity and specificity in group C were higher than those in groups A and B(sensitivity: 56.25% vs 41.17% and 44.44%; specificity: 73.68% vs 67.86% and 63.64%, respectively). The diagnostic sensitivity, specificity and accuracy of the T4 stage were similar among all groups. There were no significant differences in volume CT dose index [(5.91 ± 2.57) mGy vs(3.24 ± 1.20) vs(3.65 ± 1.77) mGy], doselength product [(167.10 ± 99.08) mGy·cm vs(113.24 ± 54.46) mGy·cm vs(117.98 ± 32.32) mGy·cm] and effective dose [(2.52 ± 1.39) vs(1.63 ± 0.76) vs(1.73 ± 0.44) mSv] among the groups(P > 0.05). However, groups B and C received similar effective doses but lower iodine loads than group A [(300 vs 450) mgI/kg].CONCLUSION EICT combined with GSI assist allows differential diagnosis between the T1/2 and T3 stages. The ability to differentially diagnose the T3 and T4 stages of medullary ESCC can be improved by quantitatively and qualitatively anaAIM To evaluate the T stage of esophageal squamous cell carcinoma(ESCC) using preoperative low-dose esophageal insufflation computed tomography(EICT).METHODS One hundred and twenty ESCC patients confirmed by surgery or esophagoscopy were divided into three groups. Groups B and C were injected with 300 mgI/kg contrast medium for automatic spectral imaging assist(GSI assist), while group A underwent a conventional 120 kVp computed tomography(CT) scan with a 450 mg I/kg contrast medium injection. EICT was performed in group C. Group A was reconstructed with filtered back projection, and groups B and C were reconstructed with 50% adaptive statistical iterative reconstruction. The contrast-to-noise ratio of lesion-to-mediastinal adipose tissue and the radiation dose were measured. Specific imaging features were observed, and T stage ESCCs were evaluated.RESULTS The sensitivity and accuracy of the T1/2 stage were higher in group C than in groups A and B(sensitivity: 43.75% vs 31.82% and 33.33%; accuracy: 54.29% vs 46.67% and 52.50%, respectively). With regard to the T3 stage, the sensitivity and specificity in group C were higher than those in groups A and B(sensitivity: 56.25% vs 41.17% and 44.44%; specificity: 73.68% vs 67.86% and 63.64%, respectively). The diagnostic sensitivity, specificity and accuracy of the T4 stage were similar among all groups. There were no significant differences in volume CT dose index [(5.91 ± 2.57) mGy vs(3.24 ± 1.20) vs(3.65 ± 1.77) mGy], doselength product [(167.10 ± 99.08) mGy·cm vs(113.24 ± 54.46) mGy·cm vs(117.98 ± 32.32) mGy·cm] and effective dose [(2.52 ± 1.39) vs(1.63 ± 0.76) vs(1.73 ± 0.44) mSv] among the groups(P > 0.05). However, groups B and C received similar effective doses but lower iodine loads than group A [(300 vs 450) mgI/kg].CONCLUSION EICT combined with GSI assist allows differential diagnosis between the T1/2 and T3 stages. The ability to differentially diagnose the T3 and T4 stages of medullary ESCC can be improved by quantitatively and qualitatively ana

关 键 词：ESOPHAGEAL NEOPLASMS tomography tumor STAGING 

分 类 号：R57[医药卫生—消化系统]