The Diagnostic Value of Dual-energy CT Multi-parameters in Differentiating Colorectal Cancer from Inflammatory Thickening of the Colorectal Wall.

Authors

Haobo Zhang, Ting Liu, Wei Gao, Lu Zhu, Zhenxing Yang, Fene Hao

Published in

Current medical imaging. Sep 23, 2026. Epub Sep 23, 2026.

Abstract

To compare and analyse the differences in dual-energy CT multi-parametric features between Colorectal Cancer (CRC) and Inflammatory Bowel Disease (IBD)-related colorectal wall thickening, and to evaluate their clinical application value.
A retrospective analysis was conducted on 300 patients with localized colorectal wall thickening who underwent dual-energy CT scans at our hospital between 2018 and 2025. After exclusions, 260 patients were included and divided into CRC (n = 140) and IBD (n = 120) groups. Measured parameters included Iodine Concentration (IC), Normalized IC (NIC), Effective Atomic Number (Zeff), Normalized Zeff (N-Zeff), Dual-Energy Index (DEI), Normalized DEI (N-DEI), CT40keV, CT100keV, and slope λ. Univariate and multivariate logistic regression identified independent predictors and constructed a combined model. ROC curves evaluated diagnostic performance.
Significant differences were observed between groups for multiple arterial and venous parameters (p < 0.05). IC_AP, NIC_AP, CT40keV_AP, IC_VP, NIC_VP, CT40keV_VP, and λ_VP were independent predictors. The combined model achieved the highest AUC (0.937), sensitivity (91.9%), and specificity (84.8%); NICVP was the best individual parameter (AUC = 0.823).
Dual-energy CT offers advantages over conventional CT in radiation dose and diagnostic accuracy, especially when endoscopy is not feasible. Venous-phase parameters generally outperformed arterial-phase parameters; NIC_VP was the best single parameter, and the combined model was superior.
DECT multi-parametric analysis demonstrates clinical value in differentiating CRC from IBD, offering a non-invasive alternative that may reduce unnecessary colonoscopies, particularly when endoscopy is unsuccessful or contraindicated.

PMID:
42786831
Bibliographic data and abstract were imported from PubMed on 25 Sep 2026.

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