Related Experiment Video
Updated: Feb 9, 2026
Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer
Jing Li1,2, Mengjie Fang3,4, Rui Wang1
1Department of Radiology, The First Affiliated Hospital of Zhengzhou University, No. 1, East Jianshe Road, Zhengzhou, 450052, Henan, China.
Objectives:
To develop and validate a dual-energy CT based nomogram for the preoperative prediction of lymph node metastasis (LNM) in patients with gastric cancer (GC).
Methods:
A total of 210 surgically confirmed GC patients (159 males, 51 females; mean age: 59.8 ± 7.7 years, range: 28-79 years) who underwent spectral CT scans were retrospectively enrolled and split into a primary cohort (n = 140) and validation cohort (n = 70). Clinical information and follow-up data including overall survival (OS) and progression-free survival (PFS) were collected. The iodine concentration (IC) of the primary tumors at the arterial phase (AP) and venous phase (VP) were measured and then normalized to the aorta (nICs). Univariate, multivariable logistic regression and Cox regression analyses were performed to screen predictive indicators for LNM and outcome. A nomogram for risk factors of LNM was developed, and its performance was measured using the ROC, accuracy and Harrell's concordance index (C-index).
Results:
Tumor thickness, Borrmann classification and ICVP were independent predictors of LNM. The nomogram was significantly associated with LN status (p < 0.001). It yielded an AUC of 0.793 [95% confidence interval (95% CI), 0.678-0.908] and an accuracy of 0.757 (95% CI, 0.640-0.852) in the internal-validation cohort. The nomogram also exhibited a prognostic ability with C-indices of 0.675 (95% CI, 0.571-0.779; p < 0.001) for PFS and 0.643 (95% CI, 0.518-0.768; p = 0.025) for OS.
Conclusion:
This study presented a dual-energy quantification-based nomogram, which can be used to facilitate the preoperative individualized prediction of LNM in patients with GC.
Key Points:
• This study first developed and internally validated a dual-energy CT-based nomogram to predict lymph node metastasis in patients with gastric cancer. • The nomogram incorporated the clinical risk factors and iodine concentration, which would enable superior preoperative individual prediction of lymph node metastasis and add more information for the optimal therapeutic strategy. • The nomogram also exhibited a significant prognostic ability for progression-free and overall survival.
More Related Videos
07:13Comparison of Predictive Performance of Three Lymph Node Staging Systems in Colorectal Signet Ring Cell Carcinoma Based on Machine Learning Model
Published on: April 18, 2025
06:46Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery
Published on: September 27, 2024
Related Concept Videos
01:23Detailed Structure and Function of Lymph Nodes
From a histological perspective, lymph nodes can be split into two main areas: the superficial cortex and the deep medulla. The outer cortex is populated by dendritic cells, macrophages, and B lymphocytes, which are densely packed into follicles. When these B-lymphocytes are presented...
03:37Uncertainty in Measurement: Accuracy and Precision
02:07Improving Translational Accuracy
02:30Metastasis
Epithelial-to-Mesenchymal Transition
The epithelial-to-mesenchymal transition or EMT is a developmental process commonly observed in wound healing, embryogenesis, and cancer metastasis. EMT is induced by transforming growth factor-beta (TGF-β) or receptor tyrosine kinase (RTK) ligands, which further...
02:27Predicting Molecular Geometry
04:10What is Energy?