Value of Gemstone Energy Spectrum CT Multi-parameter Imaging in Differential Diagnosis and Preoperative Staging of Liver Tumors

Objective: To investigate the value of gemstone energy spectrum CT (GSI) multi-parameter imaging in differential diagnosis and preoperative staging of liver tumors. Methods: Ninety-two patients with suspected hepatic malignant tumors were retrospectively selected. All patients underwent GSI scanning. Quantitative parameters[slope of energy spectrum curve (s-SHC), standard iodine concentration (NIC), portal phase NIC, iodine concentration difference (ICD), and hepatic artery iodine fraction (AIF)] were obtained. The differential value of s-SHC, arterial phase NIC, portal venous phase NIC and AIF for hepatocellular carcinoma was analyzed by ROC Value. Kappa consistency test was used to test the consistency of GSI in preoperative staging and pathological diagnosis of hepatocellular carcinoma. Results: 54 patients with liver cancer (malignant group), 38 with benign liver lesions (benign group), malignant group s-SHC[(1.93±0.62) vs (0.85±0.36)], arterial phase NIC[(0.13±0.05) vs (0.06±0.02)], portal NIC[(0.47±0.14) vs (0.40±0.13)], AIF[(0.65±0.19) vs (0.31±0.12)] were higher than benign group (P<0.05), ICD[(7.15±2.39) ×102μg/cm³vs (11.82±3.56) ×102μg/cm³] was lower than the benign group (P<0.05). The efficacy of s-SHC and arterial phase NIC in the diagnosis of liver cancer was higher. The AUC was 0.830 and 0.719, respectively. AIF had no diagnostic value. The preoperative staging accuracy rate of GSI for diagnosis of liver cancer was 77.78%, which was consistent with pathological diagnosis (Kappa value=0.612, P<0.05). Conclusion: GSI parameters s-SHC and arterial NIC have high application value in differential diagnosis of hepatic tumors. GSI technology can accurately staging hepatocellular carcinoma before operation and provide reliable guidance for clinical surgical treatment.