Title: Predictive value of preoperative CT enhancement rate and CT perfusion parameters in
colorectal cancer
Version: 1 Date: 12 Nov 2023
Reviewer's report:
Your manuscript was organized to show that predictive value of preoperative CT enhancement
rate and CT perfusion parameters in colorectal cancer. however it's not enough to be accepted
to this journal.
Major revise
1. Is there any consideration of the possibility that the contrast agent trend may be affected by
the different dominant vessels depending on the anatomical location of the primary colorectal
cancer site?
2. The contrast dose is fixed at 65 ml. However, it is known that CT values in contrast-enhanced
CT may vary depending on body weight, and the contrast agent dosage may be adjusted
depending on body weight. Is there any discussion on this point?
3. Page 10, line 14: “it can determine tumor malignancy and whether metastasis
happened easily.”Although the correlations between CT perfusion parameters and MVD or
tumor markers were indicated, the prognosis of patients in this study was not indicated.
Therefore, the direct relation between CT perfusion parameters and the prognosis is unclear,
and the impact of study seems to be a little weak in clinical course. Tumor markers can also be
evaluated less invasively.
4. Please describe future perspective more. CT perfusion is not a commonly-used preoperative
evaluation method. Importance of assessment of tumor angiogenesis before operation is unclear
in this paper.
5. Furthermore, detailed characteristics of the tumors in this study were not shown such as the
TNM stage, size, location, and pathological findings, which could affect tumor angiogenesis
and prognosis. This may make it difficult for readers to understand the content.
6. I think it is difficult to accurately identify the location of the tumor on CT images, especially
small or benign lesion. Were there any methods or criteria to select patients or lesions?
Minor revise
1. Page 1, line 13: Is this study retrospective?
2. Page 1, line 13; page 2, line 39; page 4, line 33: Is the MVD cut-off value of 35/mm2 the
median or the mean?
3. Page1 Line 23#time to park # time to peak
4. Page2 Line 24#tumour # tumor
5. Page 2, line 22; page 4, line 25: Abbreviations of VEGF and TFF3 are duplicated.
6. Page 3 Inclusion criteria (1): What is the reason for including only symptomatic patients in
the criteria?
7. Page4 Line 6#Premeability # Permeability
8. Page4 Line 32#fileds # fields
9. Page 5, line 8: Tabe 3 # Table 4
10. Page9 Line 11#neovascularisation # neovascularization
11. Page9 Line 11#tumour # tumor
12. Page 9, line 16: Is the reference 9 correct? In the reference 9, neither CT perfusion nor the
prognosis after chemotherapy were mentioned.
13. Page10 Line 10#MDV # MVD
14. Page10 Line 10#angiogensis # angiogenesis
15. Page11 Line 29#analysed # analyzed
Title: Predictive value of preoperative CT enhancement rate and CT perfusion parameters in
colorectal cancer
Version: 1 Date: 12 Nov 2023
Reviewer's report:
Your manuscript was organized to show that predictive value of preoperative CT enhancement
rate and CT perfusion parameters in colorectal cancer. however it's not enough to be accepted
to this journal.
Major revise
1. Is there any consideration of the possibility that the contrast agent trend may be affected by
the different dominant vessels depending on the anatomical location of the primary colorectal
cancer site?
2. The contrast dose is fixed at 65 ml. However, it is known that CT values in contrast-enhanced
CT may vary depending on body weight, and the contrast agent dosage may be adjusted
depending on body weight. Is there any discussion on this point?
3. Page 10, line 14: “it can determine tumor malignancy and whether metastasis
happened easily.”Although the correlations between CT perfusion parameters and MVD or
tumor markers were indicated, the prognosis of patients in this study was not indicated.
Therefore, the direct relation between CT perfusion parameters and the prognosis is unclear,
and the impact of study seems to be a little weak in clinical course. Tumor markers can also be
evaluated less invasively.
4. Please describe future perspective more. CT perfusion is not a commonly-used preoperative
evaluation method. Importance of assessment of tumor angiogenesis before operation is unclear
in this paper.
5. Furthermore, detailed characteristics of the tumors in this study were not shown such as the
TNM stage, size, location, and pathological findings, which could affect tumor angiogenesis
and prognosis. This may make it difficult for readers to understand the content.
6. I think it is difficult to accurately identify the location of the tumor on CT images, especially
small or benign lesion. Were there any methods or criteria to select patients or lesions?
Minor revise
1. Page 1, line 13: Is this study retrospective?
2. Page 1, line 13; page 2, line 39; page 4, line 33: Is the MVD cut-off value of 35/mm2 the
median or the mean?
3. Page1 Line 23#time to park # time to peak
4. Page2 Line 24#tumour # tumor
5. Page 2, line 22; page 4, line 25: Abbreviations of VEGF and TFF3 are duplicated.
6. Page 3 Inclusion criteria (1): What is the reason for including only symptomatic patients in
the criteria?
7. Page4 Line 6#Premeability # Permeability
8. Page4 Line 32#fileds # fields
9. Page 5, line 8: Tabe 3 # Table 4
10. Page9 Line 11#neovascularisation # neovascularization
11. Page9 Line 11#tumour # tumor
12. Page 9, line 16: Is the reference 9 correct? In the reference 9, neither CT perfusion nor the
prognosis after chemotherapy were mentioned.
13. Page10 Line 10#MDV # MVD
14. Page10 Line 10#angiogensis # angiogenesis
15. Page11 Line 29#analysed # analyzed
Please review this paper.
user
Title: Predictive value of preoperative CT enhancement rate and CT perfusion parameters in
colorectal cancer
Version: 1 Date: 12 Nov 2023
Reviewer's report:
Your manuscript was organized to show that predictive value of preoperative CT enhancement
rate and CT perfusion parameters in colorectal cancer. however it's not enough to be accepted
to this journal.
Major revise
1. Is there any consideration of the possibility that the contrast agent trend may be affected by
the different dominant vessels depending on the anatomical location of the primary colorectal
cancer site?
2. The contrast dose is fixed at 65 ml. However, it is known that CT values in contrast-enhanced
CT may vary depending on body weight, and the contrast agent dosage may be adjusted
depending on body weight. Is there any discussion on this point?
3. Page 10, line 14: “it can determine tumor malignancy and whether metastasis
happened easily.”Although the correlations between CT perfusion parameters and MVD or
tumor markers were indicated, the prognosis of patients in this study was not indicated.
Therefore, the direct relation between CT perfusion parameters and the prognosis is unclear,
and the impact of study seems to be a little weak in clinical course. Tumor markers can also be
evaluated less invasively.
4. Please describe future perspective more. CT perfusion is not a commonly-used preoperative
evaluation method. Importance of assessment of tumor angiogenesis before operation is unclear
in this paper.
5. Furthermore, detailed characteristics of the tumors in this study were not shown such as the
TNM stage, size, location, and pathological findings, which could affect tumor angiogenesis
and prognosis. This may make it difficult for readers to understand the content.
6. I think it is difficult to accurately identify the location of the tumor on CT images, especially
small or benign lesion. Were there any methods or criteria to select patients or lesions?
Minor revise
1. Page 1, line 13: Is this study retrospective?
2. Page 1, line 13; page 2, line 39; page 4, line 33: Is the MVD cut-off value of 35/mm2 the
median or the mean?
3. Page1 Line 23#time to park # time to peak
4. Page2 Line 24#tumour # tumor
5. Page 2, line 22; page 4, line 25: Abbreviations of VEGF and TFF3 are duplicated.
6. Page 3 Inclusion criteria (1): What is the reason for including only symptomatic patients in
the criteria?
7. Page4 Line 6#Premeability # Permeability
8. Page4 Line 32#fileds # fields
9. Page 5, line 8: Tabe 3 # Table 4
10. Page9 Line 11#neovascularisation # neovascularization
11. Page9 Line 11#tumour # tumor
12. Page 9, line 16: Is the reference 9 correct? In the reference 9, neither CT perfusion nor the
prognosis after chemotherapy were mentioned.
13. Page10 Line 10#MDV # MVD
14. Page10 Line 10#angiogensis # angiogenesis
15. Page11 Line 29#analysed # analyzed
assistant