Energy spectrum computed tomography multi-parameter imaging in preoperative assessment of vascular and neuroinvasive status in gastric cancer

Table 1 Comparison of pathological data between two groups of gastric cancer patients

Project	LVI/PNI positive group (n = 42)	LVI/PNI negative group (n = 20)	χ2	P value
Position			2.71	0.438
Cardia	9	7
Gastric fundus	2	2
Gastric body	13	6
Gastric antrum	18	5
Differentiation			5.08	0.079
High	2	3
Middle	9	8
Low	31	9
Lauren typing			2.44	0.296
Diffuse	21	6
Intestinal	12	9
Mixed type	9	5
Lymph node metastasis			37.58	< 0.001
Yes	39	3
No	3	17

LVI: Vascular invasion; PNI: Nerve invasion.

Table 2 Comparison of energy spectrum computed tomography parameters between two groups of gastric cancer patients

Project	LVI/PNI positive group (n = 42)	LVI/PNI negative group (n = 20)	T/Z	P value
Arterial phase
CT (HU)	196.5 ± 52.7	150.7 ± 33.9	3.55	0.001
CT (HU)	87.3 ± 19.2	66.4 ± 13.1	4.4	< 0.00
Ka3m)	3.6 ± 1.2	2.8 ± 0.7	2.96	0.004
IC (× 100 μg/cm³)	19.4 ± 6.1	14.9 ± 3.8	2.96	0.004
NIC	0.1 ± 0.0	0.1 ± 0.0	2.46	0.019
Venous phase
CT4 (HU)	242.6 ± 30.4	203.1 ± 27.8	5.06	< 0.001
CT (HU)	103.4 ± 13.3	81.4 ± 11.7	6.62	< 0.001
K4n.m	4.6 ± 0.6	4.1 ± 0.6	3.58	0.001
IC (× 100 μg/cm³)	23.9 (22.4, 27.1)	22.2 (18.9, 23.2)	-3.06	0.002
NIC	0.5 (0.5, 0.6)	0.4 (0.4, 0.5)	-3.10	0.002
Delay period
CT (HU)	185.0 ± 26.6	179.4 ± 23.2	0.82	0.418
CT (HU)	80.4 ± 11.2	72.8 ± 9.9	2.58	0.012
K4n.	3.5 ± 0.5	3.6 ± 0.5	-0.44	0.658
IC (× 100 μg/cm³)	18.5 ± 2.8	18.9 ± 2.8	-0.45	0.652
NIC	0.6 ± 0.	0.5 ± 0.1	2.80	0.007

LVI: Vascular invasion; PNI: Nerve invasion; CT: Computed tomography; IC: Iodine concentration; NIC: Normalized iodine concentration.

Table 3 Prediction efficacy of spectral computed tomography parameters for vascular nerve invasion status in gastric cancer

Project	AUC (95%CI)	Youden index	Optimal threshold	Sensitivity (%)	Specificity (%)
Arterial phase
CT (HU)	0.755 (0.637-0.873)	0.498	196.0	54.76	95.00
CT (HU)	0.793 (0.837-0.977)	0.545	84.5	59.52	95.00
K (₄n)	0.725 (0.602-0.848)	0.450	3.7	50.00	95.00
IC (× 100 μg/cm³)	0.726 (0.602-0.849)	0.450	19.5	50.00	95.00
NIC	0.727 (0.593-0.862)	0.517	0.1	66.67	85.00
AP-all	0.845 (0.747-0.943)	0.548	0.9	54.76	100.00
Venous phase
CTk (HU)	0.830 (0.720-0.941)	0.633	217.6	83.33	80.00
CT (HU)	0.907 (0.837-0.977)	0.710	92.4	80.95	90.00
K	0.740 (0.606-0.875)	0.405	4.1	90.48	50.00
IC (× 100μg/cm³)	0.742 (0.607-0.876)	0.405	21.8	90.48	50.00
NIC	0.745 (0.604-0.886)	462	0.5	76.19	70.00
VP-all	0.931 (0.872-0.990)	0.760	0.7	80.95	95.00
Delay period
CT (HU)	0.560 (0.406-0.713)	0.179	155.9	92.86	25.00
CT (HU)	0.708 (0.573-0.843)	0.386	74.3	78.57	60.00
K	0.529 (0.371-0.686)	0.105	3.0	90.48	20.00
IC (× 100 μg/cm³)	0.532 (0.375-0.690)	0.081	15.9	88.10	20.00
NIC	0.702 (0.560-0.845)	0.412	0.5	76.19	65.00
DP-all	0.719 (0.584-0.854)	0.374	0.7	52.38	85.00

AUC: Area under the curve; CT: Computed tomography; IC: Iodine concentration; NIC: Normalized iodine concentration.