CT iodine map habitat analysis predicts neoadjuvant therapy response in gastric cancer

Spectral CT iodine map habitat analysis identified four perfusion subtypes in gastric cancer, with response rates to neoadjuvant therapy ranging from 75% to 17%. A model combining perfusion subtype and Lauren classification achieved AUC 0.78 in external validation.

• Retrospective, two-center study of 151 patients with gastric cancer; 54 (35.8%) were responders to neoadjuvant therapy.
• A predictive model combining perfusion subtype and Lauren classification yielded AUC 0.794 (95% CI 0.751–0.836) in internal cross-validation and 0.782 (0.605–0.909) in the external test set.
• Responders had higher volume fraction of low-perfusion habitat and lower intratumoral heterogeneity score (both p<0.05).

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