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Dual energy CT − a possible new method to assess regression of rectal cancers after neoadjuvant treatment
Author(s) -
AlNajami Issam,
Drue Henrik C.,
Steele Robert,
Baatrup Gunnar
Publication year - 2017
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.24761
Subject(s) - medicine , colorectal cancer , neoadjuvant therapy , radiology , cancer , nuclear medicine , oncology , breast cancer
Background and Objectives The measurement of tumor regression after neoadjuvant oncological treatment has gained increasing interest because it has a prognostic value and because it may influence the method of treatment in rectal cancer. The assessment of tumor regression remains difficult and inaccurate with existing methods. Dual Energy Computed Tomography (DECT) enables qualitative tissue differentiation by simultaneous scanning with different levels of energy. We aimed to assess the feasibility of DECT in quantifying tumor response to neoadjuvant therapy in loco‐advanced rectal cancer. Methods We enrolled 11 patients with histological and MRI verified loco‐advanced rectal adenocarcinoma and followed up on them prospectively. All patients had one DECT scanning before neoadjuvant treatment and one 12 weeks after using the spectral imaging scan mode. DECT analyzing tools were used to determine the average quantitative parameters; effective‐Z, water‐ and iodine‐concentration, Dual Energy Index (DEI), and Dual Energy Ratio (DER). These parameters were compared to the regression in the resection specimen as measured by the pathologist. Results Changes in the quantitative parameters differed significantly after treatment in comparison with pre‐treatment, and the results were different in patients with different CRT response rates. Conclusion DECT might be helpful in the assessment of rectal cancer regression grade after neoadjuvant treatment.