胃肠道 (GI) 癌是全球癌症相关死亡的主要原因。计算机断层扫描（CT）是消化道肿瘤诊断、评估和预后预测的重要辅助工具。能谱CT是继螺旋CT、多排CT之后的又一次重大CT革命。相比传统CT仅提供单参数解剖诊断模式成像，能谱CT可以实现多参数成像，提供丰富的图像信息，优化疾病诊断。近年来，随着能谱CT的快速发展和应用，越来越多的能谱CT在胃肠道肿瘤表征中应用的研究发表。在这篇综述中，我们获得了大量文献，重点关注胃肠道癌症的能谱 CT 成像，包括食管癌、胃癌、结直肠癌、肝癌和胰腺癌。我们发现能谱CT不仅可以在术前准确对胃肠道肿瘤进行分期，而且可以区分良恶性胃肠道肿瘤，提高图像质量，有效评估病灶的治疗反应和预后。此外，本文还讨论了能谱CT在胃肠道癌症诊断和治疗中的局限性和前景。版权所有©2023 Hong，Zhong，Lv，Liu，Fu，Zhou和Yu。

Gastrointestinal (GI) cancer is the leading cause of cancer-related deaths worldwide. Computed tomography (CT) is an important auxiliary tool for the diagnosis, evaluation, and prognosis prediction of gastrointestinal tumors. Spectral CT is another major CT revolution after spiral CT and multidetector CT. Compared to traditional CT which only provides single-parameter anatomical diagnostic mode imaging, spectral CT can achieve multi-parameter imaging and provide a wealth of image information to optimize disease diagnosis. In recent years, with the rapid development and application of spectral CT, more and more studies on the application of spectral CT in the characterization of GI tumors have been published. For this review, we obtained a substantial volume of literature, focusing on spectral CT imaging of gastrointestinal cancers, including esophageal, stomach, colorectal, liver, and pancreatic cancers. We found that spectral CT can not only accurately stage gastrointestinal tumors before operation but also distinguish benign and malignant GI tumors with improved image quality, and effectively evaluate the therapeutic response and prognosis of the lesions. In addition, this paper also discusses the limitations and prospects of using spectral CT in GI cancer diagnosis and treatment.Copyright © 2023 Hong, Zhong, Lv, Liu, Fu, Zhou and Yu.