Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer

doi:10.1007/s00330-018-5483-2

	Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer
	Li, Jing 1,2; Fang, Mengjie3,4 ; Wang, Rui 1; Dong, Di3,4 ; Tian, Jie3,4 ; Liang, Pan 1; Liu, Jie 1; Gao, Jianbo 1
刊名	EUROPEAN RADIOLOGY
	2018-12-01
卷号	28 期号:12 页码:5241-5249
关键词	Gastric cancer Dual-energy CT Lymph node metastasis Nomogram
ISSN号	0938-7994
DOI	10.1007/s00330-018-5483-2
通讯作者	Gao, Jianbo(cjr.gaojianbo@vip.163.com)
英文摘要	ObjectivesTo develop and validate a dual-energy CT based nomogram for the preoperative prediction of lymph node metastasis (LNM) in patients with gastric cancer (GC).MethodsA 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).ResultsTumor 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.ConclusionThis 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 center dot This study first developed and internally validated a dual-energy CT-based nomogram to predict lymph node metastasis in patients with gastric cancer.center dot 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.center dot The nomogram also exhibited a significant prognostic ability for progression-free and overall survival.
资助项目	National Natural and Science Fund of China[81271573]
WOS关键词	SPECTRAL CT ; IODINE CONCENTRATION ; PROGNOSTIC-FACTOR ; DISSECTION ; CARCINOMA ; RATIO
WOS研究方向	Radiology, Nuclear Medicine & Medical Imaging
语种	英语
出版者	SPRINGER
WOS记录号	WOS:000451353500036
资助机构	National Natural and Science Fund of China
内容类型	期刊论文
源URL	[http://ir.ia.ac.cn/handle/173211/25723]
专题	中国科学院自动化研究所
通讯作者	Gao, Jianbo
作者单位	1.Zhengzhou Univ, Dept Radiol, Affiliated Hosp 1, 1 East Jianshe Rd, Zhengzhou 450052, Henan, Peoples R China 2.Zhengzhou Univ, Dept Radiol, Affiliated Canc Hosp, Henan Canc Hosp, Zhengzhou 450008, Henan, Peoples R China 3.Chinese Acad Sci, Inst Automat, CAS Key Lab ofMolecular Imaging, Beijing 100190, Peoples R China 4.Univ Chinese Acad Sci, Beijing 100190, Peoples R China
推荐引用方式 GB/T 7714	Li, Jing,Fang, Mengjie,Wang, Rui,et al. Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer[J]. EUROPEAN RADIOLOGY,2018,28(12):5241-5249.
APA	Li, Jing.,Fang, Mengjie.,Wang, Rui.,Dong, Di.,Tian, Jie.,...&Gao, Jianbo.(2018).Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer.EUROPEAN RADIOLOGY,28(12),5241-5249.
MLA	Li, Jing,et al."Diagnostic accuracy of dual-energy CT-based nomograms to predict lymph node metastasis in gastric cancer".EUROPEAN RADIOLOGY 28.12(2018):5241-5249.