Whole-Volume Histogram Analysis of Spectral-Computed Tomography Iodine Maps in Gastric Cancer

Background

Surgery is the main treatment for gastric cancer (GC), but finding effective alternatives for patients who cannot have surgery is important. About 15%-20% of advanced GC cases show HER2 overexpression, which influences treatment choices. Spectral-computed tomography (sCT) helps measure material compositions, and its iodine concentration parameters can aid in diagnosing GC and predicting its depth of invasion, blood vessel growth, and response to chemotherapy. However, predicting HER2 status in GC using sCT iodine maps has not been reported before.

Aim

The goal of this study was to see if analyzing whole-volume histograms of sCT iodine maps can predict HER2 status in gastric cancer.

Methods

The study included 101 patients with confirmed GC who had preoperative sCT scans. We analyzed 19 parameters from the sCT iodine maps, such as minimum, maximum, mean, and various percentiles. We looked for correlations between these parameters and HER2 status, as well as other clinical characteristics. Receiver operating characteristic curves were used to assess how well the parameters could diagnose HER2 status.

Results

The histogram parameters like maximum, mean, standard deviation, and entropy were significantly lower in the HER2+ group compared to the HER2- group. Additionally, the classification of GC and Lauren type were strongly linked to HER2 status. The 99th percentile showed the best diagnostic performance for identifying HER2 status, with a sensitivity of 76.2%, specificity of 65.0%, and accuracy of 67.3%. All sCT histogram parameters positively correlated with HER2 status.

Conclusion

Parameters from sCT iodine map analysis, especially the 99th percentile, can be valuable imaging markers for detecting HER2 overexpression in gastric cancer.

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