Relationship Between Spectral CT Quantitative Parameters and PD-L1 Expression Status in Gastric Adenocarcinoma
10.3969/j.issn.1005-5185.2025.11.013
- VernacularTitle:能谱CT定量参数与胃腺癌PD-L1表达状态的相关性
- Author:
Qianqian CHEN
1
;
Min XU
1
;
Tiezhu REN
1
;
Yue PENG
1
;
Long MA
1
;
Wenjuan ZHANG
1
Author Information
1. 兰州大学第二医院放射科,甘肃 兰州 730030;兰州大学第二临床医学院,甘肃 兰州 730030;甘肃省医学影像重点实验室,甘肃 兰州 730030;医学影像人工智能甘肃省国际科技合作基地,甘肃 兰州 730030
- Publication Type:Journal Article
- Keywords:
Stomach neoplasms;
Adenocarcinoma;
B7-H1 antigen;
Tomography,X-ray computed;
Forecasting
- From:
Chinese Journal of Medical Imaging
2025;33(11):1215-1220
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the correlation between spectral CT-derived quantitative parameters and different programmed death-ligand 1(PD-L1)expression status in gastric adenocarcinoma,in order to provide additional imaging-based references for immunotherapy regimen selection in patients with this disease.Materials and Methods A total of 45 patients with gastric adenocarcinoma,pathologically confirmed by biopsy,who underwent PD-L1 testing prior to treatment were retrospectively enrolled from Lanzhou University Second Hospital between January 2021 and September 2023.All patients underwent baseline spectral CT scans.Based on PD-L1 expression status,patients were categorized into the higher combined positive score(CPS)group(CPS≥5)and the lower CPS group(CPS<5).From the single-energy images of arterial and venous phases,the CT values(CT40 keV,CT70 keV),effective atomic number,and iodine concentration of the lesions were measured.The standardized iodine concentration and slope of the spectral curve were calculated.Differences in spectral CT parameters between the two groups were compared.Receiver operating characteristic curves were plotted for parameters with statistically significant differences,and the area under the curve was calculated to evaluate the efficacy of each single parameter and combined parameters in distinguishing PD-L1 expression status.Results In the arterial phase,the CT40 keV,CT70 keV,iodine concentration,standardized iodine concentration,effective atomic number,and slope of the spectral curve of lesions in the higher expression group were all significantly higher than those of lesions in the lower expression group(t/Z=-3.115 to-2.725,all P<0.05),whereas no significant differences were observed in all parameters in the venous phase(all P>0.05).For the standardized iodine concentration in the enhanced arterial phase,the area under the curve for distinguishing PD-L1 expression status was 0.755(95%CI 0.612 to 0.898),with a sensitivity of 81.8%and a specificity of 65.2%.No significant differences were found between it and other single spectral CT parameters in the arterial phase(all P>0.05),and its diagnostic efficacy was similar to that of the combined parameters[the area under the curve was 0.755(95%CI 0.613 to 0.897),sensitivity was 90.9%,specificity was 52.2%].Conclusion Quantitative parameters of spectral CT in the arterial phase can predict the PD-L1 expression of gastric adenocarcinoma,which may provide a reference for the screening and immunotherapy evaluation of patients with gastric adenocarcinoma.
