Spectral CT Imaging of Lung Cancer: Quantitative Analysis of Spectral Parameters and Their Correlation with Tumor Characteristics.

RATIONALE AND OBJECTIVES: Spectral computed tomography (CT) imaging is widely used in the diagnosis of various cancers. This study aimed to analyze the characteristics of lung squamous cell carcinoma (SC) and adenocarcinoma (AC) using spectral CT imaging.

METHODS: Sixty patients who were examined via spectral CT imaging and confirmed as having AC or SC via surgery and pathology were enrolled in this research project. A spectrum CT scanner was used, and both plain and enhanced CT scans were conducted to acquire spectral images. All patients' samples were used to detect the expression of thyroid transcription factor-1 (TTF-1) and epidermal growth factor receptor (EGFR) in cancer cells via immunohistochemical methods.

RESULTS: Among the 27 cases with AC, 18 cases were identified as TTF-1 positive, 9 cases were found to be TTF-1 negative, 20 cases were confirmed as EGFR positive, and 7 cases were found to be EGFR negative. Among the 33 patients with SC, 6 cases were identified as TTF-1 positive, 27 cases were found to be TTF-1 negative, 19 cases were confirmed as EGFR positive, and 14 cases were found to be EGFR negative. No statistically significant differences were observed in normalized iodine concentration (NIC), K values, and calcium content between the TTF-1-positive and TTF-1-negative groups when considering patients. Statistically significant differences in NIC and K values were noted between the EGFR-positive and EGFR-negative groups among patients with AC, but no such difference was observed regarding calcium content. Significant differences in NIC, K values, and calcium content were observed between the EGFR-positive and EGFR-negative groups among patients with SC.

CONCLUSIONS: In lung cancer cells, the parameters of spectral CT imaging, including NIC and K values, reflect the microvessel density and blood supply. Calcium content is an indicator of the growth status of lung SC.