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

Issam Al-Najami; Henrik C. Drue; Robert Steele; Gunnar Baatrup

doi:10.1002/jso.24761

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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Abstract

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 language	English
Pages (from-to)	984-988
Number of pages	5
Journal	Journal of Surgical Oncology
Volume	116
Issue number	8
Early online date	13 Jul 2017
DOIs	https://doi.org/10.1002/jso.24761
Publication status	Published - 15 Dec 2017

Keywords

Effective-Z
Pathological response
Tumor regression

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/jso.24761

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

abstract = "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.",

keywords = "Effective-Z, Pathological response, Tumor regression",

author = "Issam Al-Najami and Drue, {Henrik C.} and Robert Steele and Gunnar Baatrup",

note = "Funding information: The Research foundation of the Region of Southern Denmark; Kr{\ae}ftens Bek{\ae}mpelse; Odense Universitetshospital; Syddansk Universitet.",

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doi = "10.1002/jso.24761",

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T1 - Dual energy CT - a possible new method to assess regression of rectal cancers after neoadjuvant treatment

AU - Al-Najami, Issam

AU - Drue, Henrik C.

AU - Steele, Robert

AU - Baatrup, Gunnar

N1 - Funding information: The Research foundation of the Region of Southern Denmark; Kræftens Bekæmpelse; Odense Universitetshospital; Syddansk Universitet.

PY - 2017/12/15

Y1 - 2017/12/15

N2 - 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.

AB - 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.

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KW - Pathological response

KW - Tumor regression

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SP - 984

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JO - Journal of Surgical Oncology

JF - Journal of Surgical Oncology

IS - 8

ER -

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

Abstract

Keywords

UN SDGs

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