Total iodine uptake in CT for predicting results of neoadjuvant chemotherapy in gastric cancer

doi:10.16139/j.1007-9610.2019.01.008

Abstract

Abstract: Objective To evaluate prospectively the total iodine uptake (TIU) from dual-energy computed tomography (DECT) in predicting treatment efficacy and progression-free survival (PFS) time in the patients with gastric cancers after neoadjuvant chemotherapy (NAC). Methods Forty-four patients with locally advanced gastric cancer were given DECT before and after NAC. Changes in percentage of tumor area (%ΔS), diameter (%ΔD), and density (%ΔHU) were calculated to evaluate the WHO, RESCIST, and Choi criteria. Changes in percentage of tumor volume (%ΔV) and TIU in portal phase (%ΔTIU-p) were also calculated to determine cut-off points by ROC curves. Correlations between criteria and histomorphologic tumor regression grade (Becker) and between criteria and PFS were analyzed. Results Patients were divided into responders group and non-responders group by ΔV (43.34%, P=0.002) and by ΔTIU-p (63.87%, P=0.002), respectively. Higher correlation was present between criteria %ΔTIU-p and Becker grade (r=0.602, P<0.001) and moderate correlation between criteria %ΔV and Becker grade (r=0.416, P=0.005), while no correlation between Becker grade and WHO criteria (r=0.075, P=0.627), RECIST criteria (r=0.270, P=0.077) and Choi criteria (r=0.238, P=0.120). There were statistical diffe-rences significantly in PFS time of the patients between responder group and non-responder group when using criteria %ΔTIU-p (P=0.001) or Choi criteria (P=0.013). Conclusions TIU-p could be used to predict pathological regression in patients with advanced gastric cancer after NAC. Criteria %ΔTIU-p would become the parameter to study PFS time after NAC.

Key words: Gastric cancer, Neoadjuvant chemotherapy, Total iodine uptake, Pathologic regression, Progression-free survival

CLC Number:

R735.2

ZHANG Yang, ZHANG Huan, DING Bei, YUAN Fei, MA Qianchen, WANG Baisong, YAN Fuhua, DU Lianjun. Total iodine uptake in CT for predicting results of neoadjuvant chemotherapy in gastric cancer[J]. Journal of Surgery Concepts & Practice, 2019, 24(01): 33-39.

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