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Spectral CT in patients with colorectal cancer: quantitative contrast lesional assessment of mucinous and non-mucinous peritoneal metastases using virtual monoenergetic imaging.

Abdominal radiology (New York) 2025

Grange R, Si-Mohamed S, Benzerdjeb N, Gavrel M, Galan A, Glehen O, Kepenekian V, Rousset P

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[PURPOSE] To objectively evaluate quantitative image parameters-signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)-of peritoneal metastases (PMs) from colorectal cancer (CRC) on virtual mon

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  • p-value p < 0.05

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BibTeX ↓ RIS ↓
APA Grange R, Si-Mohamed S, et al. (2025). Spectral CT in patients with colorectal cancer: quantitative contrast lesional assessment of mucinous and non-mucinous peritoneal metastases using virtual monoenergetic imaging.. Abdominal radiology (New York). https://doi.org/10.1007/s00261-025-05355-3
MLA Grange R, et al.. "Spectral CT in patients with colorectal cancer: quantitative contrast lesional assessment of mucinous and non-mucinous peritoneal metastases using virtual monoenergetic imaging.." Abdominal radiology (New York), 2025.
PMID 41454946

Abstract

[PURPOSE] To objectively evaluate quantitative image parameters-signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR)-of peritoneal metastases (PMs) from colorectal cancer (CRC) on virtual monoenergetic images (VMIs) reconstructed from dual-layer spectral CT (DLCT) technology.

[MATERIALS AND METHODS] This prospective single-center study included consecutive patients scheduled for cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) between September 1, 2023, and May 1, 2025. All patients underwent contrast-enhanced DLCT < 7 days before surgery. SNR, CNR between PMs and mesenteric fat (CNR ), CNR between PMs and adjacent organ (CNR ) were calculated on VMIs ranging from 40 to 200 keV. PMs were classified as mucinous (mPMs) or non-mucinous (nmPMs) based on histopathology. PM conspicuity and sharpness were also evaluated between 40 and 120 keV.

[RESULTS] A total of 92 PMs (24 mPMs, 68 nmPMs) in 55 patients were analyzed. For both mPMs and nmPMs, attenuation, SNR, CNR , CNR , were highest at 40 keV (42.47 ± 23.81, 3.00 ± 2.01, 12.36 ± 3.78, 7.30 ± 3.71, and 131.16 ± 50.17, 9.88 ± 5.38, 21.89 ± 10.57, 5.62 ± 3.07, respectively) and decreased with increasing energy levels. In nmPMs, CNR and SNR declined significantly from at 50 keV onward (p < 0.05). Image noise remained stable across the 40-200 keV range. PM conspicuity and sharpness were significantly higher at 40 keV (p < 0.05).

[CONCLUSION] Low-energy VMIs obtained from spectral CT significantly improve SNR and CNR of PMs, particularly for nmPMs, supporting their integration into preoperative reading protocols.

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