Predictive Value of FORCE Open Source CT Dual-energy Imaging in Preoperative Lymph Node Metastasis of Resectable Colon Cancer

Li YANG; Yu CHEN; Longxiangfeng HU; Mengyu XIE

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Li YANG, Yu CHEN, Longxiangfeng HU, Mengyu XIE. Predictive Value of FORCE Open Source CT Dual-energy Imaging in Preoperative Lymph Node Metastasis of Resectable Colon Cancer[J]. Journal of Kunming Medical University.

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Predictive Value of FORCE Open Source CT Dual-energy Imaging in Preoperative Lymph Node Metastasis of Resectable Colon Cancer

Department of Radiology，Mianyang Central Hospital，Mianyang Sichuan 621000，China

Received Date: 2025-12-30

Abstract

Abstract

Objective To investigate the predictive value of FORCE open source CT dual energy imaging in preoperative lymph node metastasis of resectable colon cancer. Methods A retrospective study was performed to enroll 213 patients with resectable colon cancer who were admitted to Mianyang Central Hospital from January 2021 to February 2025. All patients underwent preoperative dual-energy computed tomography （CT） imaging. With postoperative pathological examination as the gold standard, the patients were divided into the lymph node metastasis group and the non-lymph node metastasis group. Clinical data and the differences in dual-energy CT imaging parameters between the two groups were compared. Lasso-Logistic regression analysis was applied to identify the influencing factors of preoperative lymph node metastasis. The receiver operating characteristic （ROC） curve analysis was used to evaluate the predictive value of dual-energy CT imaging parameters and their combined parameters for preoperative lymph node metastasis, and external validation was carried out to verify the predictive efficacy. Results The lymph node metastasis group demonstrated a larger tumor diameter and higher rates of infiltrative morphology, poor differentiation, vascular tumor thrombus, and BD3-grade tumor budding than the non-lymph node metastasis group （P < 0.05）. The arterial iodine concentration （AIC）, arterial normalized iodine concentration（ANIC）, arterial spectral curve slope （λHU-A）, arterial electron cloud density （Rho-A）, rterial effective atomic number （Zeff-A）, venous iodine concentration （VIC）, venous normalized iodine concentration （VNIC）, venous spectral curve slope （λ_HU-V）, venous electron cloud density （Rho-V）, venous effective atomic number （Zeff-V） in lymph node metastasis group were higher than those in non-lymph node metastasis group （P < 0.05）. Logistic regression analysis indicated that tumor diameter, differentiation grade, vascular tumor thrombus, AIC, λ_HU--A, Rho-A, Zeff-A, VIC, and Rho-V were independently associated with lymph node metastasis （P < 0.05）. ROC curve analysis showed the area under the curve （AUC） values of AIC, λ_HU-A, Rho-A, Zeff-A, VIC, and Rho-V for predicting preoperative lymph node metastasis were 0.726, 0.758, 0.763, 0.719, 0.727, and 0.784, respectively, with the combined predictive model achieving an AUC of 0.893. Calibration curves showed good consistency between predicted and observed probabilities （Hosmer-Lemeshow χ² = 5.683, P = 0.487）. External validation confirmed the combined model had an AUC of 0.894, sensitivity of 84.62%, specificity of 84.21%, and excellent agreement between predicted and actual probabilities （Hosmer-Lemeshow χ² = 5.418, P = 0.502）. Conclusion AIC, λ_HU-A, Rho-A, Zeff-A, VIC and Rho-V obtained from FORCE open-source dual-energy CT are closely correlated with preoperative lymph node metastasis in colon cancer, and exhibit favorable predictive value for lymph node metastasis.
- Computer tomography,
- Colorectal cancer,
- Lymph node metastasis,
- Prediction

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References(25)

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