Objective This study aims to investigate the value of extracellular volume(ECV)in quantitatively assess-ing the differentiation degree of colon cancer using dual-layer spectral CT(DLCT).Methods 106 cases of colon cancer patients who underwent DLCT examination were retrospectively collected.According to the postoperative pathological exami-nation results,the patients were divided into a high-grade group of 24 cases(poorly differentiated and mucinous adenocar-cinoma)and a low-grade group of 82 cases(moderately differentiated and highly differentiated).The differences in iodine concentration(IC),normalized iodine concentration(NIC),effective atomic number(Z-effective,Zeff),and ECV(％)of tumors at different grades were compared.Joint parameters were constructed,and ROC(Receiver Operating Characteris-tic,ROC)curves were plotted for indicators with statistically significant differences.The Delong test was used to compare the differences between various parameters.Results During the venous phase,IC,Zeff,and delayed-phase Zeff,IC,NIC,and delayed-phase ECV(％)showed significant correlations with the differentiation degree of colon cancer.The val-ues of these parameters were higher in the high-grade group compared to the low-grade group.The quantitative parameters during the delayed phase were as follows:Zeff(8.357±0.192 vs.8.13±0.251),IC(1.988±0.394 mg/ml vs.1.527±0.324 mg/ml),NIC(0.566±0.103 vs.0.432±0.080),and ECV(35.019±6.132％vs.26.484±4.873％).All these differences were statistically significant(all P＜0.05).Among all parameters,delayed-phase ECV(％)showed higher diagnostic performance,with an AUC of 0.865 and a Youden index of 0.626.When the diagnostic threshold was set at 30.33％,the sensitivity was 83.33％and the specificity was 79.27％,and the AUC of delayed-phase ECV(％)is higher than that of venous-phase IC and Zeff,and the differences are statistically significant(both P＜0.05),the delayed-phase combined parameter AUC is slightly higher than ECV(％),but the difference is not statistically significant.Con-clusion The ECV based on DLCT has high diagnostic value in assessing the differentiation degree of colon cancer.
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