Lai YF, Liang ZM, Li JF, Zhang JY, Xu DH, Dai HY. Spectral computed tomography parameters of primary tumors and lymph nodes for predicting tumor deposits in colorectal cancer. World J Radiol 2025; 17(4): 103359 [DOI: 10.4329/wjr.v17.i4.103359]
Corresponding Author of This Article
Hai-Yang Dai, MD, Department of Radiology, Huizhou Central People’s Hospital, No. 41 North Eling Road, Huizhou 516001, Guangdong Province, China. d.ocean@163.com
Research Domain of This Article
Radiology, Nuclear Medicine & Medical Imaging
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Yi-Fan Lai, Zhao-Ming Liang, Jia-Ying Zhang, Ding-Hua Xu, Hai-Yang Dai, The First Clinical College, Guangdong Medical University, Zhanjiang 524023, Guangdong Province, China
Yi-Fan Lai, Zhao-Ming Liang, Jing-Fang Li, Jia-Ying Zhang, Hai-Yang Dai, Department of Radiology, Huizhou Central People’s Hospital, Huizhou 516001, Guangdong Province, China
Ding-Hua Xu, Department of Radiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang 524001, Guangdong Province, China
Co-corresponding authors: Ding-Hua Xu and Hai-Yang Dai.
Author contributions: Lai YF, Liang ZM, Li JF, Dai HY participated in the conception and design of the study; Lai YF, Liang ZM, Li JF, Zhang JY, Dai HY were involved in the acquisition, analysis, or interpretation of data; Lai YF wrote the manuscript; Dai HY and Xu DH accessed and verified the study data. All authors critically reviewed and approved the final manuscript to be published. Xu DH (Guangdong Medical University) and Dai HY (Huizhou Central People’s Hospital) jointly supervised and advised Lai YF’s academic training and the research work presented in this manuscript. Both supervisors contributed equally to the guidance, oversight, and critical revision of this study, designating both as co-corresponding authors for this work. We confirm that: The order of supervisors listed reflects their institutional affiliations and has been mutually agreed upon by all parties. The designation of co-corresponding authorship aligns with their equal intellectual and supervisory contributions.
Institutional review board statement: This retrospective study was approved by Huizhou Central People’s Hospital ethics committee (No. ky112024034).
Informed consent statement: This retrospective study was approved by Huizhou Central People’s Hospital ethics committee (No. ky112024034), and the requirement for informed consent was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available from the corresponding author upon reasonable request at d.ocean@163.com.
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: Hai-Yang Dai, MD, Department of Radiology, Huizhou Central People’s Hospital, No. 41 North Eling Road, Huizhou 516001, Guangdong Province, China. d.ocean@163.com
Received: November 29, 2024 Revised: March 17, 2025 Accepted: March 26, 2025 Published online: April 28, 2025 Processing time: 144 Days and 21.8 Hours
Abstract
BACKGROUND
Tumor deposits (TDs) are an independent predictor of poor prognosis in colorectal cancer (CRC) patients. Enhanced follow-up and treatment monitoring for TD+ patients may improve survival rates and quality of life. However, the detection of TDs relies primarily on postoperative pathological examination, which may have a low detection rate due to sampling limitations.
AIM
To evaluate the spectral computed tomography (CT) parameters of primary tumors and the largest regional lymph nodes (LNs), to determine their value in predicting TDs in CRC.
METHODS
A retrospective analysis was conducted which included 121 patients with CRC whose complete spectral CT data were available. Patients were divided into the TDs+ group and the TDs- group on the basis of their pathological results. Spectral CT parameters of the primary CRC lesion and the largest regional LNs were measured, including the normalized iodine concentration (NIC) in both the arterial and venous phases, and the LN-to-primary tumor ratio was calculated. Statistical methods were used to evaluate the diagnostic efficacy of each spectral parameter.
RESULTS
Among the 121 CRC patients, 33 (27.2%) were confirmed to be TDs+. The risk of TDs positivity was greater in patients with positive LN metastasis, higher N stage and elevated carcinoembryonic antigen and cancer antigen 19-9 levels. The NIC (LNs in both the arterial and venous phases), NIC (primary tumors in the venous phase), and the LN-to-primary tumor ratio in both the arterial and venous phases were associated with TDs (P < 0.05). In multivariate logistic regression analysis, the arterial phase LN-to-primary tumor ratio was identified as an independent predictor of TDs, demonstrating the highest diagnostic performance (area under the curve: 0.812, sensitivity: 0.879, specificity: 0.648, cutoff value: 1.145).
CONCLUSION
The spectral CT parameters of the primary colorectal tumor and the largest regional LNs, especially the LN-to-primary tumor ratio, have significant clinical value in predicting TDs in CRC.
Core Tip: In this study, spectral computed tomography (CT) parameters of the primary colorectal cancer (CRC) lesions and the largest regional lymph nodes (LNs) were used to predict tumor deposits in CRC. Additionally, we innovatively introduced the parameter of the LN-to-primary tumor ratio from 18F-Fluorodeoxyglucose positron emission tomography/CT into the spectral CT study. It was found that the LN-to-primary tumor ratio has greater diagnostic efficacy than the spectral CT parameters of a single region.
