Dual energy CT is useful for the prediction of mesenteric and lateral pelvic lymph node metastasis in rectal cancer
| Autor: | Ryoto Kura, Takuya Miura, Masahiko Aoki, Fumiyasu Tsushima, Shuichi Ono, Takahiro Suzuki, Kenichi Hakamada, Kentaro Sato, Satoru Tsuruta, Hiromasa Fujita, Hajime Morohashi, Yoshiyuki Sakamoto, Kotaro Umemura |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Cancer Research
business.industry Colorectal cancer Area under the curve Cancer Articles Pararectal lymph nodes medicine.disease Common iliac artery Metastasis 03 medical and health sciences Dissection 0302 clinical medicine medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis medicine.artery medicine 030211 gastroenterology & hepatology Nuclear medicine business Lymph node |
| Popis: | The aim of the present retrospective study was to investigate the predictability of dual-energy computed tomography (DECT) for pararectal lymph node (PRLN) metastasis and lateral pelvic lymph node (LPLN) metastasis in rectal cancer (RC). The present study involved 44 patients with RC who were examined by DECT and then underwent surgery between May 2015 and September 2017. LPLN dissection was performed in 24 patients. The normalized iodine concentration (nIC), the ratio of iodine concentration in the lymph node (LN) to that in the common iliac artery on DECT, of the largest PRLN and LPLN was calculated, and the association between LN metastasis and nIC was analyzed. The median nIC value for PRLNs was significantly lower in PRLN metastasis-positive cases compared with PRLN metastasis-negative cases in the arterial phase [0.18 vs. 0.25; P=0.01; cut-off, 0.24; area under the curve (AUC), 0.733] and portal phase (0.47 vs. 0.61; P=0.03; cut-off, 0.59; AUC, 0.701). A significant difference was not identified between the median maximum short axis diameter of PRLNs in PRLN metastasis-positive and metastasis-negative cases (7.6 vs. 6.4 mm; P=0.33). The nIC for LPLNs was not significantly different between LPLN metastasis-positive and metastasis-negative cases in the arterial phase (0.15 vs. 0.21; P=0.19); but was significantly lower in LPLN metastasis-positive cases compared with LPLN metastasis-negative cases in the portal phase (0.29 vs. 0.56; P=0.04; cut-off, 0.29; AUC, 0.877). The maximum short axis diameter of LPLNs was significantly larger in metastasis-positive cases compared with LPLN metastasis-negative cases (9.1 vs. 4.8 mm; P=0.03; cut-off, 7.0 mm; AUC, 0.912). In conclusion, the nIC was identified to be significantly lower in metastasis-positive cases, which may be useful for the prediction of PRLN and LPLN metastases. A combination of size-based diagnosis and DECT may increase the accuracy of preoperative diagnosis. |
| Databáze: | OpenAIRE |
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