分子影像学杂志2026，Vol.49Issue(5)：571-578,8.DOI:10.12122/j.issn.1674-4500.2026.05.02
能谱CT定量参数预测结直肠癌Ki-67表达水平:一项前瞻性研究
A prospective study on predicting Ki-67 expression level in colorectal cancer using quantitative parameters of spectral CT
摘要
Abstract
Objective To investigate the predictive value of quantitative spectral CT parameters for Ki-67 expression levels in colorectal cancer.Methods A prospective study was conducted on 59 patients who underwent pre-operative whole-abdominal spectral CT enhanced scanning at the First Affiliated Hospital of Baotou Medical College from January 2023 to July 2025 and were pathologically confirmed to have colorectal adenocarcinoma.Imaging and clinical data were collected.Patients were divided into high-expression group(Ki-67≥70%,n=40)and low-expression group(Ki-67<70%,n=19)based on the Ki-67 expression index.The CT40 keV,CT70 keV,CT100 keV values,iodine concentration(IC),and effective atomic number(Zeff)of the lesions were measured using the AW4.7 post-processing workstation during the three-phase contrast-enhanced spectral CT examination.Normalized iodine concentration(NIC)and spectral curve slope(λHU)were calculated.Differences in parameters between the two groups were compared.ROC curves were plotted to evaluate the independent and combined predictive performance of these parameters for Ki-67 expression levels.Results The three-phase IC,λHU,Zeff,CT40 keV,and CT70 keV values in the Ki-67 high-expression group were significantly higher than those in the low-expression group.The arterial phase CT100 keV and delayed-phase NIC were also significantly higher in the high-expression group compared with the low-expression group(P<0.05).ROC curve analysis showed that delayed-phase IC,NIC,and Zeff had relatively high predictive efficacy for Ki-67 expression levels(AUC=0.737,0.730,and 0.718;sensitivity=77.5%,50.0%,and 77.5%;specificity=73.7%,89.5%,and 68.4%).Conclusion Among the quantitative spectral CT parameters,delayed-phase IC,NIC,and Zeff have certain predictive value for Ki-67 expression levels in colorectal cancer,and the combination of these three parameters can improve the prospective predictive efficacy for Ki-67 expression levels.关键词
能谱CT/结直肠癌/Ki-67/术前预测Key words
spectral CT/colorectal cancer/Ki-67/preoperative prediction引用本文复制引用
边颖,陈强,张爱民,罗成茂,张宇,原小军..能谱CT定量参数预测结直肠癌Ki-67表达水平:一项前瞻性研究[J].分子影像学杂志,2026,49(5):571-578,8.基金项目
内蒙古自治区自然科学基金项目(2021MS08003) （2021MS08003）
