Research progress of the clinical application of dual-layer spectral computed tomography in gastrointestinal malignancies

Gastrointestinal malignancies were the leading causes of cancer-related deaths worldwide in 2022. Owing to the absence of typical clinical symptoms at an early stage, most patients are diagnosed at an advanced stage when the disease has usually progressed to distant metastasis. Biological agents, immune checkpoint inhibitors, and precision radiotherapy have enhanced the efficacy of systemic treatment for locally advanced and metastatic gastrointestinal malignancies. Monitoring tumor malignancy, performing molecular testing of tumors, formulating precise treatment strategies, and evaluating patient prognosis have emerged as key focus areas of research on gastrointestinal malignancies. Dual-layer spectral computed tomography (DLCT) can be used not only to assess tumor histological features but also to quantify them, providing information regarding changes in the tumor microenvironment. Spectral computed tomography is a crucial tool for the initial diagnosis, staging, response evaluation, and follow-up management of patients with gastrointestinal malignancies. This review summarizes the research progress of the clinical application of DLCT in some types of gastrointestinal malignancies, such as esophageal, gastric, and colorectal cancers.