To compare the staging accuracy of spectral computed tomography (CT) and conventional CT in patients with colorectal cancer (CRC), highlighting the clinical significance of this comparison.
Key Findings:
Spectral CT showed higher overall TNM accuracy than conventional CT (74.2% vs 63.0%, P = 0.028), with an adjusted odds ratio of 1.91 (95% CI 1.14â3.19, P = 0.014).
Superior T-stage accuracy for spectral CT (74.2% vs 57.7%, P = 0.002) and N-stage accuracy (74.8% vs 64.0%, P = 0.032).
M-stage accuracy was similar between both methods (90.7% vs 91.0%, P = 0.930).
Higher agreement with the reference standard for spectral CT in overall TNM (weighted Îș = 0.815 vs 0.795), T stage (0.759 vs 0.663), and N stage (0.599 vs 0.430).
Spectral CT demonstrated higher sensitivity for M1 detection (83.8% vs 72.2%) but slightly lower specificity (93.0% vs 95.4%).
Interpretation:
Spectral CT is independently associated with improved overall TNM staging accuracy compared to conventional CT, particularly in T and N classifications, which may enhance treatment planning.
Limitations:
The study is retrospective and may be subject to selection bias.
Results may vary based on tumor location and disease burden, and potential confounding factors should be considered.
Conclusion:
Spectral CT demonstrated higher overall TNM staging accuracy than conventional CT, primarily through improved T and N classification, while M staging performance was comparable, underscoring its potential role in clinical practice.
