Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation

Iwano, Shingo; Ito, Rintaro; Umakoshi, Hironobu; Ito, Shinji; Naganawa, Shinji

doi:10.1259/bjr.20150224

Cited by 48 publications

(37 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The recent technical advance of dual‐energy CT (DECT) has provided the material‐specific imaging, also known as material decomposition, which can separate several numbers of substances, such as water, iodine, calcium, uric acid, and fat . Especially, quantitative information for iodine distribution, among the DECT‐based material decomposition techniques, has been considered a promising tool for lesion characterization to distinguish not only malignancy from benignity but also hyperdense cystic lesions or hematomas from enhancing lesions . In the head and neck region, several studies showed iodine concentration (IC) could be useful in CT imaging of cervical lymph nodes or patients with underlying neck malignancy .…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] Especially, quantitative information for iodine distribution, among the DECT-based material decomposition techniques, has been considered a promising tool for lesion characterization to distinguish not only malignancy from benignity but also hyperdense cystic lesions or hematomas from enhancing lesions. 7,8,[10][11][12][13][14][15][16][17][18] In the head and neck region, several studies showed iodine concentration (IC) could be useful in CT imaging of cervical lymph nodes or patients with underlying neck malignancy. [19][20][21][22] Until now, a few studies have evaluated IC of thyroid nodules using the DECT data sets to find the malignancy or intranodular hemorrhage; however, they decided the individual CT images for quantification without the detailed topographic knowledge based on ultrasound, which is widely considered as reference imaging modality to assess thyroid nodule.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Lee

Seo

et al. 2018

Head & Neck

View full text Add to dashboard Cite

Background To determine the usefulness of dual‐energy CT (DECT) iodine quantification to classify the focal thyroid lesions. Methods We retrospectively enrolled a total of 76 cytopathologically confirmed focal thyroid lesions (mean size: 1.9 cm). After drawing a region of interest on the DECT‐derived iodine maps, the obtained iodine concentration values of thyroid nodules (IC_N) and normalized IC_N were compared between 3 groups: papillary thyroid carcinoma (PTC), benign nodule, and cyst. Results From all lesions, 46, 17, and 13 were assigned to the PTC, benign nodule, and cyst groups. IC_N was the highest in the benign nodule, lower in the PTC, and the lowest in the cyst (median [interquartile range]: 4.3 [3.13‐5.48], 3.15 [2.29‐4.01], 0.60 [0.33‐0.88], all P < .001). Similarly, the normalized IC_N values were all statistically different from each other (P < .05).The multi‐class area under the curves using the optimal cutoff values were 0.931 for IC_N and 0.918, 0.920 for normalized IC, respectively. Conclusion DECT iodine quantification could be helpful to classify the focal thyroid lesions.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Lee

Seo

et al. 2018

Head & Neck

View full text Add to dashboard Cite

show abstract

“…These research findings indicate that iodine uptake at the arterial phase on contrast CT may be associated with some sort of tumor histopathology such as angiogenesis and hypoxic cell. Our recent study demonstrated that the three-dimensional iodine-related attenuation (3D-IRA; also known as “iodine volume”) of primary lung cancers measured by contrast-enhanced DE-CT was significantly associated with their differentiation grade [ 15 ]. Tumor grade correlates directly with microscopic tumor invasiveness [ 16 – 18 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of locoregional invasiveness of small-sized non-small cell lung cancers by enhanced dual-energy computed tomography

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundTo investigate the correlation between iodine-related attenuation of dual-energy computed tomography (DE-CT) and the histopathological invasiveness of surgically resected primary non-small cell lung cancers (NSCLCs) ≤ 3 cm in diameter.MethodsWe selected 63 consecutive NSCLC lesions from 60 patients (32 males, 28 females; age range, 39–85 years; mean age, 68 years). After injection of iodinated contrast media, arterial phases were scanned using 140-kVp and 80-kVp tube voltages. Three-dimensional iodine-related attenuation (3D-IRA) of primary tumors at the arterial phase was computed using “lung nodule” application software. The corrected 3D-IRA normalized to the patient’s body weight and contrast medium concentration was then calculated. Single-factor analysis of variance (ANOVA) was used for comparison among tumor differentiation grade groups. Univariate and multivariate logistic regression analysis was used for the correlation between locoregional invasive tumor and clinical factors.ResultsResected tumors were histopathologically classified into well-differentiated (G1; n = 24), moderately-differentiated (G2; n = 28), and poorly-differentiated (G3; n = 11) groups by degree of tumor differentiation. The mean ± standard deviation of the 3D-IRA was 56.1 ± 22.6 HU in G1 tumours, 48.5 ± 23.9 HU in G2 tumours, and 28.4 ± 15.8 HU in G3 tumours; significant differences were observed between groups by ANOVA. (p = 0.005). Univariate logistic analysis showed that the 3D-IRA and corrected 3D-IRAs were significantly correlated with locoregional invasive tumors (p = 0.002 and p < 0.001, respectively). Multivariate logistic analysis revealed that only the corrected 3D-IRA was significantly correlated with tumor invasiveness (p = 0.003), while gender, clinical size, and solid/subsolid type were not (p = 0.950, p = 0.057 and p = 0.456, respectively).ConclusionsThe 3D-IRA of small-sized NSCLCs was significantly associated with and invasiveness. Low 3D-IRA tumors tended to have greater invasiveness than high 3D-IRA tumors.

show abstract

“…In contrast, Iwano et al . [ 27 ] reported that the iodine volume during the delayed phase of dual-phase dynamic DE-CT correlated negatively with SUV max in 27 patients with primary lung cancer.…”

Section: Discussionmentioning

confidence: 99%

Impact of pretreatment whole-tumor perfusion computed tomography and 18F-fluorodeoxyglucose positron emission tomography/computed tomography measurements on local control of non–small cell lung cancer treated with stereotactic body radiotherapy

Aoki

Akimoto

Sato

et al. 2016

Journal of Radiation Research

View full text Add to dashboard Cite

This study aimed to investigate the correlation between the average iodine density (AID) detected by dual-energy computed tomography (DE-CT) and the maximum standardized uptake value (SUVmax) yielded by [18F] fluorodeoxyglucose positron emission tomography (18F-FDG PET) for non–small cell lung cancer (NSCLC) treated with stereotactic body radiotherapy (SBRT). Seventy-four patients with medically inoperable NSCLC who underwent both DE-CT and 18F-FDG PET/CT before SBRT (50‒60 Gy in 5‒6 fractions) were followed up after a median interval of 24.5 months. Kaplan–Meier analysis was used to determine associations between local control (LC) and variables, including AID, SUVmax, tumor size, histology, and prescribed dose. The median AID and SUVmax were 18.64 (range, 1.18–45.31) (100 µg/cm3) and 3.2 (range, 0.7–17.6), respectively. No correlation was observed between AID and SUVmax. Two-year LC rates were 96.2% vs 75.0% (P = 0.039) and 72.0% vs 96.2% (P = 0.002) for patients classified according to high vs low AID or SUVmax, respectively. Two-year LC rates for patients with adenocarcinoma vs squamous cell carcinoma vs unknown cancer were 96.4% vs 67.1% vs 92.9% (P = 0.008), respectively. Multivariate analysis identified SUVmax as a significant predictor of LC. The 2-year LC rate was only 48.5% in the subgroup of lower AID and higher SUVmax vs >90% (range, 94.4–100%) in other subgroups (P = 0.000). Despite the short follow-up period, a reduction in AID and subsequent increase in SUVmax correlated significantly with local failure in SBRT-treated NSCLC patients. Further studies involving larger populations and longer follow-up periods are needed to confirm these results.

show abstract

Evaluation of lung cancer by enhanced dual-energy CT: association between three-dimensional iodine concentration and tumour differentiation

Abstract: Iodine volume measured by DECT could be a valuable functional imaging method to estimate differentiation of primary lung cancer.

Cited by 48 publications

References 28 publications

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Dual‐energy CT iodine quantification for characterizing focal thyroid lesions

Evaluation of locoregional invasiveness of small-sized non-small cell lung cancers by enhanced dual-energy computed tomography

Impact of pretreatment whole-tumor perfusion computed tomography and 18F-fluorodeoxyglucose positron emission tomography/computed tomography measurements on local control of non–small cell lung cancer treated with stereotactic body radiotherapy

Contact Info

Product

Resources

About