Objective: To assess the iodine value in dual source dual energy CT (DSDECT) for evaluating the efficacy of neoadjuvant chemotherapy on advanced gastric adenocarcinoma and comparing the standardized iodine value and non-standardized iodine value in lesions as well as the difference in reduction ratio of iodine value before and after neoadjuvant chemotherapy. Methods: A total of 48 patients with pathologically confirmed gastric adenocarcinoma via endoscopy were enrolled and neoadjuvant chemotherapy was conducted. The DSDECT images before and after chemotherapy were analyzed to compare the difference between the reduction ratio of standardized iodine values (which were normalized with abdominal aorta) and non-standardized iodine values in portal phase and delayed phase. According to RECIST1.1 criteria, patients were divided into response group and non-response group. The differences in iodine value as well as reduction ratio of iodine value of lesions before and after neoadjuvant chemotherapy were compared between response and non-response groups. Results: ① There were no significant differences in the reduction ratio of standardized iodine values and non-standardized iodine values before and after neoadjuvant chemotherapy in both portal phase and delayed phase(P>0.05). ② The iodine values after neoadjuvant chemotherapy in the response group were significantly lower than those of the non-response group in the portal phase [values are expressed as (mean ± standard deviation) or median (guartile deviation)][iodine uptake in portal phase(IU-P), （1.71±0.49） mg/mL vs （2.15±0.55）mg/mL, P=0.008; normalized iodine uptake in portal phase(NIU-P), （0.30±0.09） vs （0.38±0.10）, P=0.003; total iodine uptake in portal phase (TIU-P): 18.30 mg（27.15 mg） vs 81.55 mg（81.20 mg）, P<0.001; normalized total iodine uptake in portal phase (NTIU-P): 15.86（22.65） vs 47.97（64.05）, P<0.001]. ③ The reduction ratio of total iodine uptake before and after neoadjuvant chemotherapy in response group were significantly higher than those in non-response group in both portal and delayed phase [ΔTIU-P, -83.34%（21.05%） vs -39.82%（47.90%）, P<0.001; ΔNTIU-P, -80.28%（19.61%） vs -42.33%（41.12%）, P<0.001; ΔTIU-D, -80.66%（19.97%） vs -36.99%（37.71%）, P<0.001; ΔNTIU-D, -79.57%（24.89%） vs -37.79%（36.48%）, P<0.001]. Conclusions: The iodine values and the reduction ratio of the iodine values after neoadjuvant chemotherapy obtained from DSDECT can be helpful for evaluating the efficacy of neoadjuvant chemotherapy on advanced gastric adenocarcinoma.
ZHANG Yang, ZHANG Huan, YAN Jing, GAO Xiaoyuan, TAN Jingwen, WU Xinyang, YAN Fuhua
. Iodine value in dual source dual energy CT for evaluating the efficacy of neoadjuvant chemotherapy on advanced gastric adenocarcinoma[J]. Journal of Diagnostics Concepts & Practice, 2018
, 17(02)
: 191
-196
.
DOI: 10.16150/j.1671-2870.2018.02.014
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