Objective To evaluate the value of quantitative parameters of dual-layer spectral detector CT(SDCT)in e-valuating the expression level of Ki-67 antigen in colorectal cancer.Methods Data of 92 patients with colorectal cancer confirmed by surgery and pathology from October 2021 to September 2023 in the First Affiliated Hospital of Kunming Medi-cal University were retrospectively collected.All patients underwent abdominal three-phase enhanced scanning on SDCT.Based on Ki-67 expression level,patients were categorized into either the high-expression group(n=56,Ki-67＞50％)or the low-expression group(n=36,Ki-67 ≤50％).Parameters such as iodine concentration(IC),effective atomic number(Eff-Z),CT40 keV,CT70 keV,and CTl00keV of colorectal cancer lesions through three-phase enhanced scanning were meas-ured.Normalized iodine concentration(NIC)and energy spectrum curve slope(λHU)were calculated.The differences of parameters between the two groups in enhanced scan were compared.Spearman correlation coefficient was used to evaluate the correlation between statistically significant parameters and Ki-67 expression level.The ROC curve was drawn to observe the efficacy of each parameter for predicting Ki-67 expression level.Results Arterial IC,λHU,CT40keV were higher in high expression group than those in low expression group.There were no significant differences in arterial parameters(NIC,Eff-Z,CT70 keV,CT 100 keV)and each parameter in venous or delayed stage between the two groups(all P＞0.05).There was a weak positive correlation found between arterial IC,λHU,CT40 keV and the expression level of Ki-67(rs=0.366,0.356,0.346,all P＜0.05).ROC curve analysis showed that the diagnostic efficiency of arterial IC was the highest(AUC 0.716,sensitivity 60.7％,specificity 77.8％),followed by the arterial λHU(AUC 0.710,sensitivity 60.7％,spe-cificity 83.3％).Conclusion The SDCT quantitative parameters of arterial phase can provide more useful information for preoperative assessment of the Ki-67 expression level in colorectal cancer,and have certain clinical application value.
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