Preoperative T-staging of Colorectal Cancer by Dual-energy Computed Tomography: A Retrospective Study

Abstract

Background: Preoperative T-staging is essential for planning optimal treatment and care for colorectal cancer (CRC).

Objective: To evaluate the accuracy of Dual-energy CT (DECT) in preoperative T-staging of CRC.

Methods: The clinical data and DECT images of 37 patients with 39 CRC lesions were retrospectively analyzed. The performance of the DECT quantitative parameters in CRC T-staging was evaluated. Postoperative pathologic results were used as a gold standard. Receiver operating characteristic curves were used to assess the diagnostic efficacy of DECT parameters. P < 0.05 was deemed significant.

Results: The overall accuracy of T-staging by DECT was 76.9%. The DECT parameters were significantly different between the T3 pericolic fat stranding, T4a pericolic fat stranding, and normal pericolic fat stranding. Arterial phase λ_HU had the best diagnostic performance with a cut-off value of ≥0.967, resulting in a 70.6% sensitivity and a 100% specificity in differentiating between T3 and T4a stages of CRC.

Conclusion: DECT has high accuracy in the T-staging of CRC. Arterial phase λHU has the best diagnostic performance in differentiating between T3 and T4a stages of CRC.

Keywords: Arteries; Colorectal cancer; Colorectal neoplasms; Computed tomography.; Lymph nodes; Neoplasm staging.