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Objectives <p>This study aimed to investigate the value of dual-layer detector spectral CT (DLCT)-derived extracellular volume (ECV) in predicting lymph node metastasis (LNM), perineural invasion (PNI), and lymphovascular invasion (LVI) in colon cancer.</p> Methods <p>A total of 120 patients with histopathologically confirmed colon cancer who underwent preoperative DLCT were retrospectively enrolled. Patients were grouped based on pathological status of LNM, PNI, and LVI. Iodine concentration (IC) and effective atomic number (Zeff) were measured across arterial, venous, and delayed phases. Normalized IC (NIC), normalized Zeff (NZeff), and delayed-phase ECV were calculated. Interobserver agreement was assessed using intraclass correlation coefficient (ICC). Univariate and multivariate analyses were performed, and receiver operating characteristic curves were constructed to evaluate diagnostic performance.</p> Results <p>Delayed-phase IC, NIC, NZeff, and ECV were significantly higher in LNM-positive, PNI-positive, and LVI-positive groups than in negative groups (all <i>P</i> &lt; 0.05). Venous-phase IC, Zeff, and NIC also differed significantly between LNM and PNI subgroups (all <i>P</i> &lt; 0.05). Delayed-phase ECV achieved the highest AUCs for predicting LNM (0.735), PNI (0.723), and LVI (0.705). Combining ECV with T stage or pathological grading further improved diagnostic efficacy. ICC values indicated excellent interobserver consistency.</p> Conclusion <p>DLCT-derived delayed-phase ECV serves as a promising non-invasive imaging marker for predicting LNM, PNI, and LVI in colon cancer. Combined with clinical factors, ECV may help improve preoperative risk stratification and assist clinicians in individualized treatment planning.</p>

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The value of extracellular volume based on spectral CT in lymph node metastasis, perineural invasion, and lymphovascular invasion of colon cancer

  • 期刊论文

  • 发表日期：

    2026年5月26日

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  • Yijie Wang,
  • Jianyao Lu,
  • Yaomin Li,
  • Yaying Yang,
  • Yijun Yu,
  • Zhengyun Sun,
  • Yan Bi,
  • Yuechao Guo,
  • Qiong Zhou,
  • Wenfen Shi,
  • Yamin Li

摘要

Objectives

This study aimed to investigate the value of dual-layer detector spectral CT (DLCT)-derived extracellular volume (ECV) in predicting lymph node metastasis (LNM), perineural invasion (PNI), and lymphovascular invasion (LVI) in colon cancer.

Methods

A total of 120 patients with histopathologically confirmed colon cancer who underwent preoperative DLCT were retrospectively enrolled. Patients were grouped based on pathological status of LNM, PNI, and LVI. Iodine concentration (IC) and effective atomic number (Zeff) were measured across arterial, venous, and delayed phases. Normalized IC (NIC), normalized Zeff (NZeff), and delayed-phase ECV were calculated. Interobserver agreement was assessed using intraclass correlation coefficient (ICC). Univariate and multivariate analyses were performed, and receiver operating characteristic curves were constructed to evaluate diagnostic performance.

Results

Delayed-phase IC, NIC, NZeff, and ECV were significantly higher in LNM-positive, PNI-positive, and LVI-positive groups than in negative groups (all P < 0.05). Venous-phase IC, Zeff, and NIC also differed significantly between LNM and PNI subgroups (all P < 0.05). Delayed-phase ECV achieved the highest AUCs for predicting LNM (0.735), PNI (0.723), and LVI (0.705). Combining ECV with T stage or pathological grading further improved diagnostic efficacy. ICC values indicated excellent interobserver consistency.

Conclusion

DLCT-derived delayed-phase ECV serves as a promising non-invasive imaging marker for predicting LNM, PNI, and LVI in colon cancer. Combined with clinical factors, ECV may help improve preoperative risk stratification and assist clinicians in individualized treatment planning.