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Can quantitative iodine parameters on DECT replace perfusion CT parameters in colorectal cancers?

Hyo-Jin Kang1,2, Se Hyung Kim3,4, Jae Seok Bae1,2

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European Radiology
|May 24, 2018
PubMed
Summary

Dual-energy CT (DECT) iodine parameters correlate with perfusion CT (PCT) findings in colorectal cancer. DECT offers better reproducibility and significantly lower radiation exposure, making it a viable alternative to PCT.

Keywords:
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Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Colorectal cancer (CRC) diagnosis and monitoring rely on imaging techniques.
  • Perfusion CT (PCT) provides functional information but involves higher radiation doses.
  • Dual-energy CT (DECT) offers material decomposition, including iodine quantification.

Purpose of the Study:

  • To assess the correlation between iodine concentrations from DECT and PCT parameters in CRC.
  • To evaluate the reproducibility of DECT and PCT measurements.
  • To compare the radiation exposure of DECT and PCT for CRC imaging.

Main Methods:

  • Prospective enrollment of 41 patients with pathologically proven CRC.
  • Same-day DECT and PCT acquisition.
  • Independent analysis of tumor iodine concentration, iodine ratios (IRa, IRv), blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) by three radiologists.
  • Statistical analysis using Pearson R, linear correlation, paired t-test, and intraclass correlation coefficients (ICCs).

Main Results:

  • Significant correlations were observed between DECT iodine parameters and PCT parameters (e.g., tumor iodine concentration and BV/PMB/MTT; IRa/IRv and MTT/BF/PMB).
  • DECT demonstrated superior intra- and interobserver agreement compared to PCT for all measured parameters.
  • DECT exhibited significantly lower radiation doses (CTDIvol, DLP) than PCT (p < 0.01).

Conclusions:

  • Quantitative iodine parameters from DECT show significant correlation with PCT parameters in CRC.
  • DECT offers improved intra- and interobserver agreement over PCT.
  • DECT provides a valuable alternative to PCT for CRC imaging due to its comparable diagnostic information and substantially reduced radiation exposure.