Association between spectral computed tomography images and clinicopathological features in advanced gastric adenocarcinoma

To investigate the role of spectral computed tomography (CT)-generated iodine concentration (IC) in the evaluation of clinicopathological features of advanced gastric adenocarcinoma (AGC), 42 patients who underwent abdominal enhanced CT with spectral imaging mode were selected for the present study. The IC of the primary lesion in the arterial phase (IC(AP)) and portal venous phase (IC(VP)) was measured and the IC of the aorta was used for a normalized iodine concentration (nIC). Micro-vessel density (MVD) and lymphatic vessel density (LVD) were detected using immunohistochemical assays against cluster of differentiation 34 and D2-40, respectively. Other clinicopathological characteristics were also documented. The IC parameters were revealed to be significantly increased in the high-MVD group, particularly for the nIC(VP) (P=0.002). Additionally, the nIC(AP) revealed a significant difference (P=0.041) between the high- and low-LVD group. The nIC(AP) and nIC(VP) were increased in the poorly differentiated group compared with the moderately differentiated group (P=0.040 and P=0.011, respectively). The ICs and MVD demonstrated a statistically significant positive linear correlation. nIC(VP) was able to be used to discriminate between the moderately and poorly differentiated carcinomas, with an area under the receiver operating characteristic curve of 0.759. However, IC demonstrated no correlation with serosal involvement, lymph node metastasis, LVD, and nodular or metastatic tumors. The results of the present study suggest that the nIC(VP) value may serve as a non-invasive marker for the angiogenesis of, and the differentiations between, patients with AGC.