Objective: To compare the spectral computed tomography (CT) imaging parameters between squamous cell carcinoma (SCC) and adenocarcinoma (AC) at the gastroesophageal junction (GEJ).
Methods: A total of 80 patients were enrolled in this retrospective study. Among them, 35 were diagnosed with SCC (SCC group) and 45 were diagnosed with AC (AC group). All patients underwent an enhanced scan with spectral CT. The following CT imaging parameters were evaluated: iodine concentration (IC), water content (WC), effective atomic number (Eff-Z) and slope of the spectral HU curve (λHU) of lesions. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of spectral CT imaging parameters for diagnosis of SCC and AC.
Results: Patients with SCC had lower IC, Eff-Z, and λHU in arterial phase and venous phase compared with AC (p< 0.05). There were no significant differences in WC between the two groups. ROC curve analyses revealed that IC, Eff-Z, and λHU in arterial phase and venous phase were predictors for diagnosis of SCC and AC (AUC > 0.5). Moreover, the IC, Eff-Z and λHU in venous phase had better differential diagnostic performances than that in arterial phase.
Conclusions: Spectral CT could be useful in the differential diagnosis of SCC and AC at the GEJ. Therefore, a routine spectral CT scan is recommended for patients with carcinoma of the GEJ.
Keywords: Spectral CT; adenocarcinoma; gastroesophageal junction; squamous cell carcinoma.