The Concentration of Iodine in Perigastric Adipose Tissue: A Novel Index for the Assessment of Serosal Invasion in Patients with Gastric Cancer after Neoadjuvant Chemotherapy

摘要

Objective: This study aims to explore the association between iodine concentration (IC) in perigastric adipose tissue (PAT), quantified by dual-energy computed tomography (DECT) and serosal invasion (SI) in patients with gastric cancer post-neoadjuvant chemotherapy (NAC). Methods: Fortythree patients with T4-staged gastric cancer were enrolled. IC and standardized IC in PAT (ICPAT and SICPAT) were quantified by DECT pre and post NAC. A postoperative pathologic examination was performed to stage gastric cancer. Results: After NAC, a total of 43 participants were assigned to group A with 13 patients and group B with 30 patients according to the results of the postoperative pathologic examination. The accuracy of conventional CT in identifying SI was 74.42%. Differences of variations between pre-and post-NAC ICPAT, SICPAT, Delta ICPAT, and Delta SICPAT were observed respectively (p 0.05). Intragroup ICPAT and SICPAT also changed significantly after NAC (p 0.05). The area under the ROC curve was 0.929, with the threshold of Delta SICPAT reaching 0.095. The sensitivity, specificity, and accuracy of SICPAT in identifying post-NAC SI were 92.30, 86.70, and 88.37% respectively. Moreover, the 2 measurements in the same patient maintain a high level of consistency. Conclusion: These results showed that SICPAT is a reliable index for identifying post-NAC SI. (C) 2018 S. Karger AG, Basel