Diagnostic Value of Dual-Energy CT Iodine Mapping in Differentiating Malignant and Benign Cervical Lymphadenopathies.

IF 1.2 4区医学 Q3 ACOUSTICS

Journal of Clinical Ultrasound Pub Date : 2025-04-16 DOI:10.1002/jcu.24014

Mustafa Başaran, Fatma Beyazal Çeliker, Metin Çeliker, Kemal Panç, Enes Gürün

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引用次数: 0

Abstract

Purpose: To evaluate the diagnostic accuracy of Dual-Energy Computed Tomography (DECT) in distinguishing malignant from benign cervical lymph nodes in neck carcinoma based on iodine concentration and normalized spectral attenuation (Hounsfield Unit, HU) values.

Methods: Retrospective DECT scan analysis was performed on 52 neck carcinoma patients, analyzing 52 metastatic and 28 reactive lymph nodes. Iodine concentration (mg/mL) and spectral HU values were measured with circular regions of interest on iodine maps. Metastatic nodes included 27 from squamous cell carcinoma (SCC), 19 from lymphoma, and 6 from papillary thyroid carcinoma (PTC).

Results: Metastatic lymph nodes had lower iodine levels than reactive nodes (1.45 vs. 1.85 mg/mL, p = 0.011). No significant difference in spectral HU values was found (117 vs. 111 HU, p = 0.328). An iodine threshold of 1.62 mg/mL demonstrated 71% sensitivity and 77% specificity for detecting malignancy (AUC = 0.673, 95% CI: 0.54-0.80, p = 0.011). SCC metastases had lower iodine levels than reactive nodes (1.33 vs. 1.85 mg/mL, p < 0.001), while PTC metastases had higher levels (2.39 vs. 1.85 mg/mL, p = 0.038).

Conclusion: DECT iodine quantification improves the detection of cervical lymph node metastases, particularly in cases with equivocal size criteria. Incorporating iodine measurements with tumor type knowledge improves diagnostic accuracy, aiding in prognosis and treatment planning.

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双能CT碘标测在鉴别颈淋巴肿物良恶性中的诊断价值。

目的：评价双能计算机断层扫描（DECT）基于碘浓度和归一化谱衰减（Hounsfield Unit， HU）值区分颈癌颈淋巴结良恶性的诊断准确性。方法：回顾性分析52例颈癌患者的DECT扫描，分析52例转移淋巴结和28例反应性淋巴结。碘浓度（mg/mL）和光谱HU值在碘图上用感兴趣的圆形区域测量。转移淋巴结包括27例鳞状细胞癌，19例淋巴瘤，6例甲状腺乳头状癌。结果：转移性淋巴结的碘水平低于反应性淋巴结（1.45 vs. 1.85 mg/mL, p = 0.011）。光谱HU值差异无统计学意义（117比111 HU， p = 0.328）。碘阈值为1.62 mg/mL，检测恶性肿瘤的敏感性为71%，特异性为77% （AUC = 0.673, 95% CI: 0.54-0.80, p = 0.011）。SCC转移灶的碘水平低于反应性淋巴结（1.33 vs 1.85 mg/mL），结论：DECT碘定量可提高颈部淋巴结转移的检测，特别是在大小标准不明确的情况下。结合碘测量与肿瘤类型知识提高诊断准确性，有助于预后和治疗计划。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Clinical Ultrasound 医学-核医学

CiteScore

1.90

自引率

0.00%

发文量

248

审稿时长

6 months

期刊介绍： The Journal of Clinical Ultrasound (JCU) is an international journal dedicated to the worldwide dissemination of scientific information on diagnostic and therapeutic applications of medical sonography. The scope of the journal includes--but is not limited to--the following areas: sonography of the gastrointestinal tract, genitourinary tract, vascular system, nervous system, head and neck, chest, breast, musculoskeletal system, and other superficial structures; Doppler applications; obstetric and pediatric applications; and interventional sonography. Studies comparing sonography with other imaging modalities are encouraged, as are studies evaluating the economic impact of sonography. Also within the journal''s scope are innovations and improvements in instrumentation and examination techniques and the use of contrast agents. JCU publishes original research articles, case reports, pictorial essays, technical notes, and letters to the editor. The journal is also dedicated to being an educational resource for its readers, through the publication of review articles and various scientific contributions from members of the editorial board and other world-renowned experts in sonography.