Role of CT perfusion imaging in patients with variously differentiated gastric adenocarcinoma

Article type: Research Article

Authors: Sun, Zong-Qiong^a | Cheng, Xiao-Fang^b | Ge, Yu-Xi^a | Chen, Lin^a | Yue, Jian-Guo^a | Jin, Lin-Fang^c | Xie, Zhi-Hui^d | Zhang, Han-Di^e | Xuan, Ying-Hua^{f; *}

Affiliations: [a] Department of Radiology, Affiliated Hospital of Jiangnan University, The Forth People's Hospital of Wuxi City, Wuxi, Jiangsu, China | [b] Department of Radiology, Guanzhou Hui-Ai Hospital, Guangzhou, Guangdong, China | [c] Department of Pathology, Affiliated Hospital of Jiangnan University, The Forth People's Hospital of Wuxi City, Wuxi, Jiangsu, China | [d] Department of Surgical Gastroenterology, Affiliated Hospital of Jiangnan University, The Forth People's Hospital of Wuxi City, Wuxi, Jiangsu, China | [e] Mental Health Center, Shantou University, Shantou, Guangdong, China | [f] Department of Basic Medicine, Jiangnan University Medical School, Wuxi, Jiangsu, China

Correspondence: [*] Corresponding author: Ying-Hua Xuan, Department of Basic Medicine, Jiangnan University, Wuxi, Jiangsu 214062, China. Tel.: +86 18112385686; E-mail:[email protected]

Abstract: PURPOSE: To explore the characteristics of variously differentiated gastric cancers on computed tomography (CT) perfusion imaging, including specific perfusion parameter values, and potential clinical applications in the prognosis assessment of gastric cancer. MATERIALS AND METHODS: Fifty patients with gastric cancer confirmed by gastroscope pathology were studied prospectively using CT perfusion imaging examinations on a 64-slice spiral CT scanner. The acquired volume data were used for calculations, mapping, and analysis by using an abdominal tumor perfusion protocol (deconvolution method) in the CT perfusion software package to measure 4 parameters: blood flow (BF), blood volume (BV), mean transit time (MTT), and the permeability surface (PS) area product. The different differentiated Gastric cancers with CT perfusion values were divided into 3 groups: well-differentiated, moderately differentiated and poorly differentiated gastric adenocarcinoma, and compared statistically with one another by statistical software. RESULTS: The mean perfusion values of 10 patients with well-differentiated gastric adenocarcinoma were as follows: BF, 75.28 ± 6.81 mL/100 g/min; BV, 9.01 ± 0.94 mL/100 g; MTT, 9.89 ± 1.65 s; and PS, 10.05 ± 0.71 mL/100 g/min. The mean perfusion values of 24 patients with moderately differentiated gastric adenocarcinoma were as follows: BF, 110.01 ± 31.90 mL/100 g/min; BV, 18.18 ± 5.62 mL/100 g; MTT, 9.81 ± 3.69 s; and PS, 40.08 ± 15.82 mL/100 g/min. The mean perfusion values of 16 patients with poorly differentiated gastric adenocarcinoma were as follows: BF, 138.59 ± 38.09 mL/100 g/min; BV, 21.08 ± 4.11 mL/100 g; MTT, 9.47 ± 1.80 s; and PS, 57.50 ± 13.28 mL/100 g/min. Comparing the 3 groups, differences between the well-differentiated group and the moderate differentiation group were all statistically significant for BF, BV, and PS (p < 0.05, respectively), differences between the well-differentiated group and the poor differentiation group were all statistically significant for BF, BV, and PS (p < 0.05,respectively) as well; While MTT value showed no statistical difference among the 3 groups (p > 0.05). CONCLUSION: Stomach CT perfusion imaging is a functional imaging technology from the perspective of hemodynamics with potential clinical applications. The BF, BV and PS values could serve as indicators of the degree of malignancy and aid in prognostic assessment of gastric cancer.

Keywords: Gastric cancer, differentiation, CT, perfusion imaging, prognosis

DOI: 10.3233/XST-150524

Journal: Journal of X-Ray Science and Technology, vol. 23, no. 6, pp. 737-744, 2015