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Original Research

Open Access

Quantitative evaluation of myelosuppression after chemotherapy for patients with ovarian cancer using material decomposition in dual-energy computed tomography

  • Wanjing Bai1,3,*,
  • Lin Li2,3
  • Gang Ning1,3,*,
  • Xuesheng Li1,3
  • Xijian Chen1,3
  • Lingjun Jiang1,3
  • Xueru Yang1,3
  • Hanhong Zhou1,3

1Department of Radiology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China

2Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, 610041 Chengdu, Sichuan, China

3Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, 610041 Chengdu, Sichuan, China

DOI: 10.22514/ejgo.2023.009 Vol.44,Issue 1,February 2023 pp.79-86

Submitted: 13 July 2022 Accepted: 22 September 2022

Published: 15 February 2023

*Corresponding Author(s): Wanjing Bai E-mail:
*Corresponding Author(s): Gang Ning E-mail:


Objective: To demonstrate feasibility of quantifying myelosuppression after chemother-apy for patients with ovarian cancer (OC) using fat density measurement on material decomposition (MD) images in dual-energy computed tomography (DECT). Materials and methods: Fifty-seven patients with OC after chemotherapy underwent DECT. MD using fat and hydroxyapatite (HAP) as basis material pair was performed. Regions of interest (ROIs) of 20 mm2 were placed on bone marrow of ilia and femoral shafts bilaterally at level of coronal hip joint and the third sagittal lumbar vertebra to measure fat density on FAT (HAP) MD images. Eight characteristics (age, pathological type, International Federation of Gynaecology and Obstetrics (FIGO) stage, unilateral/bilateral, chemotherapy protocol and cycle, days after therapy (DAT), and ROI location) were recorded. Fat densities in ilia and femoral shafts were compared bilaterally with paired sample t tests and among 3 ROI locations with Kruskal-Wallis tests. Regression and correlations were made between fat density and 8 characteristics. Regression equations, correlation coefficients, scatterplot and normal probability plot (P-P) are provided. Results: There were no statistically significant differences in fat density in ilia or femoral shafts bilaterally (p > 0.05). Average fat densities were significantly different with 916.93 ± 9.3 in ilia, 927.04 ± 11.86 in femoral shaft, and 932.18 ± 8.45 in lumbar vertebra (p < 0.001). Regression equation was Y = 923.26 − 0.29 × age + 0.05 × pathological-type − 0.94 × FIGO stage + 0.82 × unilateral/bilateral − 0.54 × chemotherapy-protocol + 0.52 × chemotherapy-cycle + 0.01 × DAT + 7.63 × ROI location, with correlation coefficients with age, DAT and ROI location at −0.23, 0.16 and 0.53, respectively (p < 0.05). Conclusions: Myelosuppression after chemotherapy manifests as fat substitute and can be quantified by measuring fat density on FAT (HAP) images. Fat density was significantly correlated with patient age, DAT and measurement locations.


Ovarian cancer; Chemotherapy; Myelosuppression; Dual-energy CT; Material decomposition; Fat quantification

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Wanjing Bai,Lin Li,Gang Ning,Xuesheng Li,Xijian Chen,Lingjun Jiang,Xueru Yang,Hanhong Zhou. Quantitative evaluation of myelosuppression after chemotherapy for patients with ovarian cancer using material decomposition in dual-energy computed tomography. European Journal of Gynaecological Oncology. 2023. 44(1);79-86.


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