Correlation between dual-energy spectral CT imaging parameters and pathological grades of non-small cell lung cancer

Lin, Liulan; Zhang, Y.; Suo, Shiteng; Zhang, F.; Cheng, Jian; Wu, Huawei

doi:10.1016/j.crad.2017.11.004

Cited by 42 publications

(39 citation statements)

References 24 publications

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“…DECT allows the quantitative assessment of the concentration of iodine accumulated in a unit of tissue volume. Recent studies have showed the correlation of the iodine accumulation in the pulmonary nodule with the type of primary or metastatic tumor [28], pathological grades of non-small cell lung cancer [29,30], and tumor gene expression [31][32][33]. Son YJ et al [30], analyzing the DECT results in patients with pure ground-glass opacity nodules or part solid nodules with solid components less than 5 mm in diameter, concluded that DECT with the quantitative analysis of iodine concentration parameters improved the power of diagnostic accuracy in distinguishing invasive adenocarcinoma from adenocarcinoma in situ or a minimally invasive one in comparison to results obtained in virtual non-contrast images (VNC) alone.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Solitary Pulmonary Nodules Based on Virtual Monochrome Images and Iodine-Dependent Images Using a Single-Source Dual-Energy CT with Fast kVp Switching

Żegadło

Żabicka

Kania-Pudło

et al. 2020

JCM

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With lung cancer being the most common malignancy diagnosed worldwide, lung nodule assessment has proved to be one of big challenges of modern medicine. The aim of this study was to examine the usefulness of Dual Energy Computed Tomography (DECT) in solitary pulmonary nodule (SPN) assessment. Between January 2017 and June 2018; 65 patients (42 males and 23 females) underwent DECT scans in the late arterial phase (AP) and venous phase (VP). We concluded that imaging at an energy level of 65 keV was the most accurate in detecting malignancy in solitary pulmonary nodules (SPNs) measuring ≤30 mm in diameter on virtual monochromatic maps. Both virtual monochromatic images and iodine concentration maps prove to be highly useful in differentiating benign and malignant pulmonary nodules. As for iodine concentration maps, the analysis of venous phase images resulted in the highest clinical usefulness. To summarize, DECT may be a useful tool in the differentiation of benign and malignant SPNs. A single-phase DECT examination with scans acquired 90 s after contrast media injection is recommended.

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Section: Discussionmentioning

confidence: 99%

Assessment of Solitary Pulmonary Nodules Based on Virtual Monochrome Images and Iodine-Dependent Images Using a Single-Source Dual-Energy CT with Fast kVp Switching

Żegadło

Żabicka

Kania-Pudło

et al. 2020

JCM

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“…In addition, nICPP has been reported to exert a high sensitivity in differentiating malignant gastric mucosal lesions from normal gastric mucosa [ 11 ]. Furthermore, studies on the diagnostic efficacy of tumor differentiation degree are inconsistent [ 35 , 36 ], which may be due to the different biological behaviors of tumors and degrees of differentiation. A previous study has found that the values of IC and nIC of poorly differentiated adenocarcinoma are not significantly different compared to those of moderately and well-differentiated adenocarcinomas in AP [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Wang

et al. 2018

Cancer Imaging

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BackgroundComputed tomography (CT) imaging is the most common imaging modality for the diagnosis and staging of gastric cancer. The aim of this study is was to prospectively explore the ability of quantitative spectral CT parameters in the detection of gastric cancer and its histologic types.MethodsA total of 87 gastric adenocarcinoma (43 poorly and 44 well-differentiated) patients and 36 patients with benign gastric wall lesions (25 inflammation and 11 normal), who underwent dual-phase enhanced spectral CT examination, were retrospectively enrolled in this study. Iodine concentration (IC) and normalized iodine concentration (nIC) during arterial phase (AP) and portal venous phase (PP) were measured thrice in each patient by two blinded radiologists. Moreover, intraclass correlation coefficient (ICC) was used to assess the interobserver reproducibility. Differences of IC and nIC values between gastric cancer and benign lesion groups were compared using Mann-Whitney U test. Furthermore, the gender, age, location, thickness and histological types of gastric adenocarcinoma were analyzed by Mann-Whitney U test or Kruskal-Wallis H test. Receiver operating characteristic (ROC) curves were used to evaluate the diagnostic efficacy of IC and nIC values, and the optimal cut-off value was calculated with Youden J.ResultsAn excellent interobserver agreement (ICC > 0.6) was achieved for IC. Notably, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in gastric cancer group (Z = 5.870, 3.894, 2.009 and 10.137, respectively; P < 0.05) than those in benign lesion group. Additionally, the values of ICAP, ICPP, nICAP and nICPP were significantly higher in poorly differentiated gastric adenocarcinoma group (Z = 4.118, 5.637, 6.729 and 2.950, respectively; P < 0.005) than those in well-differentiated gastric adenocarcinoma group. There were no statistically significant differences in the values of ICAP, ICPP, nICAP and nICPP between age, gender, tumor thickness and tumor location. Furthermore, the area under the curve (AUC) values of ICAP, nICAP, ICPP and nICPP were 0.745, 0.584, 0.662, and 0.932, respectively, for gastric cancer detection; while 0.756, 0.919, 0.851 and 0.684, respectively, in discriminating poorly differentiated gastric adenocarcinoma.ConclusionIC values exhibited great potential in the preoperative and non-invasive diagnosis of gastric cancer and its histological types. In particular, nICPP is more effective for the identification of gastric cancer, whereas nICAP is more effective in discriminating poorly differentiated gastric adenocarcinoma.

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“…Iodine quantification parameters from DECT are significantly correlated with perfusion CT parameters, 28 which can reflect the blood flow and assess the tumor vascularity. 12 , 29 , 30 Angiogenesis is critical for tumor growth and metastasis. 31 Previous research revealed a significant correlation between tumor invasiveness and angiogenesis in TET patients, 22 and thymoma subtypes and thymic squamous cell carcinomas differed significantly in their vascular structure and expression of angiogenic growth factors.…”

Section: Discussionmentioning

confidence: 99%

“…Dual-energy CT (DECT) is a relatively new technique offering specific tissue characterization through application of different x-ray spectra, which can be used to quantitatively measure iodine concentration (IC) reflecting the information about tumor contrast enhancement and angiogenesis. 10 – 12 Compared with the conventional CT or perfusion CT, DECT could reduce the radiation dose and pseudoenhancement effects, 13 which has been increasingly used for oncologic imaging in recent few years. 11 , 12 , 14 – 21 A previous CT research showed that the maximal contrast-enhanced range in type A and type AB thymomas were significantly higher than other TETs.…”

mentioning

confidence: 99%

“… 10 – 12 Compared with the conventional CT or perfusion CT, DECT could reduce the radiation dose and pseudoenhancement effects, 13 which has been increasingly used for oncologic imaging in recent few years. 11 , 12 , 14 – 21 A previous CT research showed that the maximal contrast-enhanced range in type A and type AB thymomas were significantly higher than other TETs. 9 Initial studies reported that DECT can be helpful in differentiating mediastinal tumors.…”

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confidence: 99%

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Iodine Quantification Using Dual-Energy Computed Tomography for Differentiating Thymic Tumors

Wang¹,

Xin²,

Jing³

et al. 2018

J Comput Assist Tomogr

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PurposeThe aim of the study was to explore the efficacy of iodine quantification with dual-energy computed tomography (DECT) in differentiating thymoma, thymic carcinoma, and thymic lymphoma.Materials and MethodsFifty-seven patients with pathologically confirmed low-risk thymoma (n = 16), high-risk thymoma (n = 15), thymic carcinoma (n = 14), and thymic lymphoma (n = 12) underwent chest contrast-enhanced DECT scan were enrolled in this study. Tumor DECT parameters including iodine-related Hounsfield unit (IHU), iodine concentration (IC), mixed HU (MHU), and iodine ratio in dual phase, slope of energy spectral HU curve (λ), and virtual noncontrast (VNC) were compared for differences among 4 groups by one-way analysis of variance. Receiver operating characteristic curve was used to determine the efficacy for differentiating the low-risk thymoma from other thymic tumor by defined parameters.ResultsAccording to quantitative analysis, dual-phase IHU, IC, and MHU values in patients with low-risk thymoma were significantly increased compared with patients with high-risk thymoma, thymic carcinoma, and thymic lymphoma (P < 0.05/4).The venous phase IHU value yielded the highest performance with area under the curve of 0.893, 75.0% sensitivity, and 89.7% specificity for differentiating the low-risk thymomas from high-risk thymomas or thymic carcinoma at the cutoff value of 34.3 HU. When differentiating low-risk thymomas from thymic lymphoma, the venous phase IC value obtained the highest diagnostic efficacy with the area under the curve of 0.969, and sensitivity, specificity, and cutoff value were 87.5%, 100.0%, and 1.25 mg/mL, respectively.ConclusionsIodine quantification with DECT may be useful for differentiating the low-risk thymomas from other thymic tumors.

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Correlation between dual-energy spectral CT imaging parameters and pathological grades of non-small cell lung cancer

Cited by 42 publications

References 24 publications

Assessment of Solitary Pulmonary Nodules Based on Virtual Monochrome Images and Iodine-Dependent Images Using a Single-Source Dual-Energy CT with Fast kVp Switching

Assessment of Solitary Pulmonary Nodules Based on Virtual Monochrome Images and Iodine-Dependent Images Using a Single-Source Dual-Energy CT with Fast kVp Switching

Detection of gastric cancer and its histological type based on iodine concentration in spectral CT

Iodine Quantification Using Dual-Energy Computed Tomography for Differentiating Thymic Tumors

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