Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

Prognostic role of iodine values for gastric cancer after neoadjuvant chemotherapy: a strong independent prognostic factor

1.

Department of Radiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China

2.

Department of Radiology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, China

3.

Department of Pathology, Shanghai Jiao Tong University School of Medicine, Ruijin Hospital, Shanghai, China

Diagn Interv Radiol 2022; 28: 388-395
DOI: 10.5152/dir.2022.201007
Read: 771 Downloads: 227 Published: 01 September 2022

PURPOSE 
We aimed to systematically explore the value of iodine values calculated from dual-energy computed tomography (DECT) as potential prognostic factors for locally advanced gastric cancer (LAGC) patients undergoing neoadjuvant chemotherapy (NAC).

METHODS
Eighty-five LAGC patients were examined using DECT before and after NAC and were divided into responders and non-responders based on the tumor regression grade (TRG). The iodine values, including portal- and delayed-phase iodine uptake (IU-p and IU-d, mg/ml) and total iodine uptake (TIU-p and TIU-d, mg) were acquired. Correlations between the reduction ratios of iodine values and TRG were analyzed. The diagnostic performance of parameters for differentiating responders from non-responders was calculated. Kaplan-Meier method was used for survival analysis.

RESULTS 
The reduction ratios of total iodine uptake (%△TIU-p and %△TIU-d) were significantly correlated with TRG (p < 0.001). The ypN stage, %△TIU-p and %△TIU-d were significant factors influencing PFS (p < 0.050). A value of %△TIU-d≤62.19% was associated with negative prognosis [relative risk (RR):2.103; P = 0.021], as was ypN stage (RR:4.250; p = 0.003).

CONCLUSION
Iodine values (especially the TIU) are noninvasive quantitative parameters that are potentially helpful for evaluating the treatment response and survival prognosis of LAGC after NAC. %△TIU-d represents a strong independent prognostic factor, increasing preoperative risk assessment performance.

You may cite this article as: Zhang Y, Chen J, Yuan F, Zhang B, Ding B, Zhang H. Prognostic role of iodine values for gastric cancer after neoadjuvant chemotherapy: a strong independent prognostic factor. Diagn Interv Radiol. 2022;28(5):388-395.

Files
EISSN 1305-3612