Dual energy CT - a possible new method to assess regression of rectal cancers after neoadjuvant treatment

Issam Al-Najami (Lead / Corresponding author), Henrik C. Drue, Robert Steele, Gunnar Baatrup

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    Background and Objectives: The measurement of tumor regression after neoadjuvant oncological treatment has gained increasing interest because it has a prognostic value and because it may influence the method of treatment in rectal cancer. The assessment of tumor regression remains difficult and inaccurate with existing methods. Dual Energy Computed Tomography (DECT) enables qualitative tissue differentiation by simultaneous scanning with different levels of energy. We aimed to assess the feasibility of DECT in quantifying tumor response to neoadjuvant therapy in loco-advanced rectal cancer.

    Methods: We enrolled 11 patients with histological and MRI verified loco-advanced rectal adenocarcinoma and followed up on them prospectively. All patients had one DECT scanning before neoadjuvant treatment and one 12 weeks after using the spectral imaging scan mode. DECT analyzing tools were used to determine the average quantitative parameters; effective-Z, water- and iodine-concentration, Dual Energy Index (DEI), and Dual Energy Ratio (DER). These parameters were compared to the regression in the resection specimen as measured by the pathologist.

    Results: Changes in the quantitative parameters differed significantly after treatment in comparison with pre-treatment, and the results were different in patients with different CRT response rates.

    Conclusion: DECT might be helpful in the assessment of rectal cancer regression grade after neoadjuvant treatment.

    Original languageEnglish
    Pages (from-to)984-988
    Number of pages5
    JournalJournal of Surgical Oncology
    Issue number8
    Early online date13 Jul 2017
    Publication statusPublished - 15 Dec 2017


    • Effective-Z
    • Pathological response
    • Tumor regression


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