ISSN 1305-3825 | E-ISSN 1305-3612
Abdominal Imaging - Original Article
Dual-Energy CT characteristics of colon and rectal cancer allows differentiation from stool by dual-source CT
1 Department of Radiology, Hacettepe University School of Medicine, Ankara, Turkey  
2 Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey  
3 Department of General Surgery, Hacettepe University School of Medicine, Ankara, Turkey  
Diagn Interv Radiol ; : -

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Abstract

Purpose: To determine dual-energy computed tomography (DECT) characteristics of colorectal cancer and investigate effectiveness of DECT method in differentiating tumor from stool in patients with colorectal cancer.

 

Material and methods: Fifty consecutive patients with colorectal tumors were enrolled. Staging computed tomography (CT) was performed by DECT method (80-140kV) using dual-source CT after rectal air insufflation and without bowel preparation. Both visual and quantitative analyses were performed on 80kV, 140kV, iodine map and virtual non-contrast (VNC) images.

 

Results: All colorectal tumors had homogeneous pattern on iodine map. Stools demonstrated heterogeneous pattern in 86% (43/50) and homogeneous pattern in 14% (7/50) on iodine maps and were less visible on VNC images. Median density of tumors was 54 (18 – 100) HU and 28 (11 – 56) HU on iodine map and VNC images, respectively. Median density of stool was 36.5 (8 – 165) HU and -135.5 (-438 – -13) HU on iodine map and VNC images, respectively. The density of stools was significantly lower than tumors on both iodine map and VNC images (P < 0.001). The cut-off point of density measurement on VNC images was -1 HU with area under the curve of 1, a sensitivity and specificity of 100.0%.

 

Conclusion: Density or visual analysis of iodine map and VNC DECT images allows accurate differentiation of tumor from stool.

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