Spectral computed tomography in advanced gastric cancer: Can iodine concentration non-invasively assess angiogenesis?

• Published in: World journal of gastroenterology : WJG Vol. 23; no. 9; pp. 1666 - 1675
• Main Authors: Chen, Xiao-Hua, Ren, Ke, Liang, Pan, Chai, Yaru, Chen, Kui-Sheng, Gao, Jian-Bo
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 07.03.2017
• Subjects: Adult; Aged; Antigens, CD34 - metabolism; Biopsy; Carcinoma - diagnostic imaging; Female; Humans; Immunohistochemistry; Iodine - chemistry; Linear Models; Male; Microcirculation; Middle Aged; Neovascularization, Pathologic; Prospective Study; Radiographic Image Interpretation, Computer-Assisted; Radiography, Abdominal; Stomach Neoplasms - diagnostic imaging; Tomography, X-Ray Computed; Vascular Endothelial Growth Factor A - metabolism; Iodine concentration; Spectral computed tomography; Gastric cancer; Vascular endothelial growth factor; Micro-vessel density
• ISSN: 1007-9327; 2219-2840; 2219-2840
• DOI: 10.3748/wjg.v23.i9.1666

AIM To investigate the correlation of iodine concentration(IC) generated by spectral computed tomography(CT) with micro-vessel density(MVD) and vascular endothelial growth factor(VEGF) expression in patients with advanced gastric carcinoma(GC).METHODS Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase(AP) and venous phase(VP) were measured, and were then normalized against that in the aorta to provide the normalized IC(nI C). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nI C with MVD, VEGF, and clinical-pathological features were analyzed.RESULTS Both nI Cs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nI C-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nI C-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nI C-AP and nI C-VP showed significant differences in terms of histological differentiation and Lauren subtype.CONCLUSION The IC detected by spectral CT correlated with the MVD. n IC-AP and n IC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.