Clinical value of energy spectrum curves of dual-energy computer tomography may help to predict pathological grading of gastric adenocarcinoma

BACKGROUND: To explore the clinical value of energy spectrum curves of dual-energy computer tomography (CT) in quantitative evaluation of different pathological grades of gastric adenocarcinoma. METHODS: A total of 62 patients with 36 poorly, 25 moderately and 1 well differentiated gastric adenocarcinomas confirmed pathologically were collected. Dual-energy CT plain and enhanced scanning were undergone before operation. Dual-Energy software was used to measure the slope of the energy spectrum curves (λ) in arterial and venous phases (VPs) after image reconstruction. Patients were divided into two groups according to the pathological results, including well and moderately differentiated gastric adenocarcinoma group and poorly differentiated gastric adenocarcinoma group. Data of each group were analyzed by independent sample t-test. Receiver operating characteristic curve (ROC) was used to evaluate the diagnostic efficiency of the corresponding parameters. RESULTS: There were significant differences in λ values of 40–50, 40–60, 40–80, 40–90, 40–100, 40–120, 40–130, 40–140 and 40–150 keV energy ranges in VP between the well and moderately differentiated group and poorly differentiated group (P<0.05), but no significant differences in λ values of different energy ranges in arterial phase (AP) between the two groups (P>0.05). And the area under curve in 40–120 keV energy range was the largest in VP. λ(40–120keV)=2.69 was selected as the diagnostic threshold with the maximum Youden index, the sensitivity and specificity were 61.1% and 76%, respectively. CONCLUSIONS: The energy spectrum curve of dual-energy CT had certain diagnostic value in the quantitative evaluation of pathological grading of gastric adenocarcinoma.