Relevant Research Between Dual-source And Dual-energy CT Multiple Quantitative Parameters And Gastric Adenocarcinoma

Objective: To investigate the diagnostic efficacy of multiple quantitative parameters of dual-source CT in gastric adenocarcinoma during portal period.To evaluate the value of multiple quantitative parameters of dual-source CT in evaluating the degree of pathological differentiation of gastric adenocarcinoma in portal phase.To explore the correlation between the CT values of three phases enhanced and multiple quantitative parameters of dual-source dual-energy CT in portal phase and whether HER2 is overexpressed.Methods: A retrospective analysis was performed on 106 patients with gastric adenocarcinoma who underwent dual-source and dual-energy CT scans and obtained definite pathological results in shaanxi people's hospital from July 2018 to October2019,of which 102 were gastric tubular adenocarcinoma(21 were highly differentiated adenocarcinoma,31 were moderately differentiated adenocarcinoma,and 50 were poorly differentiated adenocarcinoma).30 normal gastric wall were used as the control group.34 cases of the 102 gastric tubular adenocarcinoma patients with gastric cancer by gastroscope biopsy got pathology results,68 patients with postoperative specimen got pathological results,postoperative specimens' HER2 is clear,including HER2 positive 12 cases and HER2 negative 56 cases.They all underwent dual source CT scan.The dual-energy images of portal period were obtained by the second-generation dual-source CT scan of Siemens,and the energy spectrum curve,the iodine concentration of portal period and the iodine concentration of the same aorta were obtained by syngo.via software.After calculation,the slope of the energy spectrum curve and the standardized iodine concentration were obtained.The CT values of the arterial phase,portal phase and equilibrium phase were measured on the original image.The data were divided into normal gastric wall and gastric adenocarcinoma groups,high,medium and low differentiated gastric adenocarcinoma groups,HER2 positive group and HER2 negative group.The statistical methods were Kappa consistency test,ROC curve method,two independent samples T test and variance analysis.Results: there was a strong consistency between biopsy and postoperative of pathological results(Kappa coefficient was 0.871),and and it was no significant difference(P<0.001).It indicates that biopsy results can basically replace postoperative pathological results.The slope of energy spectrum curve between normal gastric and gastric adenocarcinoma(1.35±0.24,2.77±0.67)was statistically significant(P<0.05),and the standardized iodine concentration(0.31±0.08,0.53±0.25)was statistically significant(P<0.05).The area under the curve of slope and standardized iodine concentration were 0.996 and 0.883 respectively.The spectrum curve slope of highly differentiated,moderately differentiated and poorly differentiated gastric adenocarcinoma(2.18±0.37,2.69±0.56,3.07±0.66)were statistically significant between and within the groups(P<0.05).Standardized iodine concentration in portal phase of high,medium and low differentiation(0.33±0.53,0.50±0.11,0.63±0.30)gastric adenocarcinoma showed statistically significant differences between the groups(P<0.05).There were no significant differences between the moderately differentiated group and the poorly differentiated group(P>0.05).However the differences between the highly differentiated group and the moderately differentiated group or the poorly differentiated group(P<0.05)were significant.The CT values of portal period between the positive group and the negative group(99.33±4.367,75.75±10.198)were statistically significant(P<0.05),while there was no significant difference(P>0.05)between the CT values of the arterial period(53.50±6.775,52.30±10.968)and the equilibrium period(103.67±10.367,78.54±13.894).The differences in slope value and normalized iodine concentration between HER2 positive group and negative group(P>0.05)were unconspicuous.Conclusion:(1)dual-energy parameters are effective in the diagnosis of gastric cancer,providing the possibility for non-invasive diagnosis of gastric cancer;(2)As a new diagnostic technique,dual-energy parameters provide a new method and idea for the clinical differentiation of gastric cancer,and can be used as a reference index for the evaluation of the differentiation of gastric cancer.(3)There was a difference in the degree of portal venous enhancement between the HER2 positive group and the HER2 negative group,but there was no significant correlation between the HER2 protein in gastric cancer and the slope of the corresponding energy spectrum curve and the standardized iodine concentration.