Contribution of DECT in detecting serosal invasion of gastric cancer

BACKGROUND/AIM: This study aimed to investigate the relationship between the iodine concentration (IC) of perigastric fat tissue as assessed by dual-energy computed tomography (DECT) and serosal invasion of gastric cancer. MATERIALS AND METHODS: A total of 41 patients underwent preoperative staging evaluation for gastric cancer using DECT between July 2015 and March 2018. Patients were divided into 2 groups based on pathology results: serosal invasion (stage T4a) and intact serosa (stages T1–T3). Cutoff values, the diagnostic efficacy of IC in the perigastric fat tissue, and the perigastric fat tissue/tumor (P/T) ratio were determined. RESULTS: Among the 41 patients, 22 had stage T4a gastric cancer and 19 patients had gastric cancer with a stage lower than T4a. The mean IC of perigastric fat tissue and the P/T ratio were significantly higher in patients with serosal invasion than in those with intact serosa (P < 0.001). During the arterial phase, the area under the curve (AUC) was 0.915 and 0.854 for the IC of perigastric fat tissue and the P/T ratio, respectively. During the venous phase, the AUC was 0.890 and 0.876 for the IC of perigastric fat tissue and the P/T ratio, respectively. CONCLUSION: The IC in the perigastric fat tissue seems to be a reliable indicator for serosal invasion of gastric cancer.