Evidence mapPaperPMID 40830775Full record

ArticleBMC medical imaging2025

Enhancing risk stratification in diabetic gastric cancer: muscle-fat ratio from photon-counting CT as a predictor of postoperative complications.

Shuangxiang Lin, Yuchen Jin, Mengxi Xu, Shuyue Wang, Weisheng Yao, Jiaxing Wu, Xinhong Wang, Jianzhong Sun

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Article in BMC medical imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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8 authors.

Shuangxiang LinDepartment of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China.
Yuchen JinDepartment of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China.
Mengxi XuDepartment of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China.
Shuyue WangDepartment of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China.
Weisheng YaoDepartment of Internal Medicine, Linhai Maternal and Child Health Care Hospital, Taizhou, 317000, China.
Jiaxing WuSiemens Healthineers, No. 399, West Haiyang Road, Shanghai, 200126, China.
Xinhong Wang *Department of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China.
Jianzhong SunDepartment of Radiology, The Second Affiliated Hospital Zhejiang, University School of Medicine, Hangzhou, 310000, China. 2191009@zju.edu.cn.

Funding

The Medical Science and Technology Project of Zhejiang Province 2021KY393
6 · The paper itself

Abstract

backgroundIn diabetic gastric cancer patients, body composition (skeletal muscle–to–fat ratio, MFR) may influence surgical outcomes. We evaluated whether Photon-counting CT (PCD-CT) derived MFR predicts major postoperative complications, reflecting its value in perioperative risk stratification.

methodsA retrospective analysis of 134 gastric cancer patients with type 2 diabetes was conducted. Preoperative PCD-CT scans assessed body composition. Logistic regression models identified predictors of poor postoperative outcomes, defined by major postoperative complications. The predictive accuracy of models incorporating clinical variables and MFR was evaluated using receiver operating characteristic curves, integrated Discrimination Improvement (IDI), and net Reclassification Improvement (NRI).

resultsPatients who developed major complications (n = 35) had significantly lower skeletal muscle area (45.5 vs. 56.2 cm²; P < 0.01) and higher fat accumulation. Abnormal MFR (0.34–0.57)was a strong predictor of poor outcomes (OR = 1.94, 95% CI: 1.17–2.58, p < 0.01) compared to patients without complications (n = 99). The model combining clinical variables with MFR had the best performance (AUC = 0.75, sensitivity = 0.74, specificity = 0.71) in predicting major complications, outperforming a model based solely on clinical factors. It also showed substantial improvements in predictive accuracy, with an NRI of 0.52 (p < 0.01) and an IDI of 0.09 (p < 0.01).

conclusionMFR, quantified by PCD-CT, is a reliable and accurate biomarker for identifying diabetic gastric cancer patients at higher risk of major postoperative complications. MFR demonstrates strong predictive value for adverse surgical outcomes, reinforcing its role in perioperative risk stratification. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Adipose TissueDiabetes Mellitus, Type 2Muscle, SkeletalPostoperative ComplicationsStomach NeoplasmsTomography, X-Ray ComputedAgedBody CompositionFemaleHumansMaleMiddle AgedRetrospective StudiesRisk AssessmentDiabeticGastric cancerMuscle-to‐fat ratioPhoton-counting CT

Identifiers

PMID40830775
PMCPMC12363078

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.