Objective To investigate the value of spectral CT extracellular volume fraction in preoperative diagnosis of pathological T stage and histological grade of colorectal cancer.Methods The clinical,pathological data and preoperative spectral CT images of 112 patients with pathologically confirmed colorectal adenocarcinoma in the Second and First Affilia-ted Hospital of Soochow University from June 2022 to December 2022 were retrospectively collected.The quantitative pa-rameters of spectral CT in three enhanced phases of the lesion were measured and analyzed,including CT value,iodine con-centration(IC)value,effective atomic number(Eff-Z)value of 40 keV and 100 keV virtual monoenergetic images(VMI)in arterial phase and venous phase,and extracellular volume fraction(ECV)value in delayed phase.The T stage and histo-logicalgrade of the tumor was obtained by surgical pathology.Independent sample t test or Mann-Whitney U test was used to compare the differences of parameters in different pathological T stages and histological grades.Spearman correlation analy-sis was used to quantitatively evaluate the correlation between T stages and parameters.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic effect of parameters with differences between groups.Results The spectral CT quantitative parameters of T3 tumors were higher than those of T1-2 tumors,and the differences were statisti-cally significant(all P＜0.05).Eff-ZAP,ICAP,CT 40 keVAP,CT 100 keVAP,Eff-ZVP,ICVP,CT 40 keVVP,CT 100 keVVP,ECV were moderately correlated with T stage(0.4＜r＜0.75),and ECV had the highest correlation with T stage(r=0.602).The Eff-ZAP,ICVP,CT 100 keVVP and ECV values of the high-grade group were higher than those of the low-grade group,and the differences were statistically significant(all P＜0.05).The preoperative diagnostic efficacy of ECV for pathological T stage and histological grade of colorectal cancer was high,with AUC values of 0.885 and 0.738,respectively.Conclusion Spectral CT extracellular volume fraction can be used for preoperative diagnosis of pathological T stage and histological grade of colorectal cancer,and the diagnostic efficiency is better than the conventional quantitative parameters of spectral CT.It can provide a new and non-invasive imaging marker for preoperative evaluation of colorectal cancer,and help to formulate individualized treatment earlier and accurately.
Spectral CTExtracellular volume fractionColorectal cancerPathological T stageHistological grade
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