Parameters of dual-energy CT for the differential diagnosis of thyroid nodules and the indirect prediction of lymph node metastasis in thyroid carcinoma: a retrospective diagnostic study

Li, Fu; Huang, Fuling; Liu, Chenmin; Pan, Denghua; Tang, Xiaoqi; Ye, Wen; Chen, Zhibai; Qin, Yuhong; Chen, Junqiang

doi:10.21037/gs-22-262

Cited by 4 publications

(5 citation statements)

References 41 publications

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“…Lee et al (16) reported that 76 patients with thyroid nodules had lower (p< 0.05) DECT-based standardized IC values for malignant thyroid nodules in the arterial phase compared to benign nodules, indicating that spectral CT could be used to assess abnormal iodine levels in patients with thyroid nodules. Similarly, in a retrospective study that included 150 patients with thyroid nodules, benign nodules examined with spectral CT exhibited higher iodine concentrations and standardized IC in the arterial phase, suggesting that IC values from spectral CT are a useful biomarker for differentiating malignant from benign nodules (8). This is generally consistent with our finding that NIC-A was both lower in malignant thyroid nodules and statistically significant in a multifactorial analysis (p< 0.001).…”

Section: Discussionsupporting

confidence: 89%

“…Computed tomography (CT) can also be used to identify thyroid nodules, provide objective images, establish preoperative localization, provide information for diagnosis, and evaluate treatment outcomes. In addition, CT overcomes the drawbacks of US and FNA, including operator dependence and invasive procedures (8). Therefore, CT examinations are increasingly used for preoperative thyroid nodule evaluation.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of benign and malignant thyroid nodules by a dual-layer spectral detector CT-based nomogram

Li²,

Xie³

et al. 2023

Front. Oncol.

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IntroductionPreoperative diagnosis of benign and malignant thyroid nodules is crucial for appropriate clinical treatment and individual patient management. In this study, a double-layer spectral detector computed tomography (DLCT)-based nomogram for the preoperative classification of benign and malignant thyroid nodules was developed and tested. MethodsA total of 405 patients with pathological findings of thyroid nodules who underwent DLCT preoperatively were retrospectively recruited. They were randomized into a training cohort (n=283) and a test cohort (n=122). Information on clinical features, qualitative imaging features and quantitative DLCT parameters was collected. Univariate and multifactorial logistic regression analyses were used to screen independent predictors of benign and malignant nodules. A nomogram model based on the independent predictors was developed to make individualized predictions of benign and malignant thyroid nodules. Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC), calibration curve and decision curve analysis(DCA). ResultsStandardized iodine concentration in the arterial phase, the slope of the spectral hounsfield unit(HU) curves in the arterial phase, and cystic degeneration were identified as independent predictors of benign and malignant thyroid nodules. After combining these three metrics, the proposed nomogram was diagnostically effective, with AUC values of 0.880 for the training cohort and 0.884 for the test cohort. The nomogram showed a better fit (all p > 0.05 by Hosmer−Lemeshow test) and provided a greater net benefit than the simple standard strategy within a large range of threshold probabilities in both cohorts. DiscussionThe DLCT-based nomogram has great potential for the preoperative prediction of benign and malignant thyroid nodules. This nomogram can be used as a simple, noninvasive, and effective tool for the individualized risk assessment of benign and malignant thyroid nodules, helping clinicians make appropriate treatment decisions.

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Section: Discussionsupporting

confidence: 89%

Section: Introductionmentioning

confidence: 99%

Diagnosis of benign and malignant thyroid nodules by a dual-layer spectral detector CT-based nomogram

Li²,

Xie³

et al. 2023

Front. Oncol.

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“…DS-DECT detects the iodine content of thyroid nodules, and the iodine content in benign nodules exceeds that of malignant nodules, indicating that thyroid lesions have implications for follicular cells and the decreased iodine metabolism in the lesion area. Moreover, DS-DECT allows for in-depth analysis of the lesion by establishing iodine images [ 28 ]. Iodine uptake by thyroid follicular cells within thyroid nodules and adenomas is reduced in the presence of hyperplasia or degeneration of thyroid tissue or incomplete degeneration within the nodule; in malignant nodules, cellular heterogeneity within the lesion is more pronounced, and thyroid follicular cells have a reduced or even absent capacity for iodine uptake [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules

Zhu

Kanglin

Wang

et al. 2022

Evidence-Based Complementary and Alternative Medicine

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Objective. To evaluate the diagnostic effectiveness of dual source dual energy computed tomography (DS-DECT) for benign and malignant thyroid nodules. Methods. Between January 2019 and December 2021, 60 patients with surgically and pathologically verified thyroid nodules treated at our institution were recruited. DS-DECT was administered to all patients. The iodine content of lesioned and normal tissues, the normalized iodine concentration (NIC) and standardized CT values of benign and malignant nodules, the consistency of examination results and pathological findings, and diagnostic effectiveness were all investigated. Results. The diagnosis accuracy was the same as that of surgical pathology, producing a 100% accuracy for the 60 patients with thyroid nodules (42 were benign and 18 were malignant). The iodine content of lesioned solid tissue differed significantly from that of normal tissue, as did the iodine content of malignant and benign nodules ( P < 0.05 ). In the arterial phase, no significant difference was found in NIC and standardized CT values between benign and malignant nodules ( P > 0.05 ). The optimal critical NIC for differentiating benign and malignant nodules in the venous phase was 0.74 and the standardized CT value was 0.79 HU according to the receiver operating characteristics (ROC) curve. Malignant nodules were diagnosed when the NIC was <0.74 and the standardized CT value was <0.79 HU, with AUC values of 0.89 and 0.93, respectively, where the sensitivity and specificity of the differential diagnosis of NIC were 90.48% (38/42) and 88.89% (16/18), respectively, and those of the differential diagnosis of standardized CT value were 92.86% (39/ 42) and 94.44% (17/18), respectively. The diagnosis accuracy of DS-DECT was 100%, and the diagnostic results of morphological characteristics and pathological testing were consistent. The sensitivity and specificity of the NIC values and standardized CT values in the venous phase differential diagnosis of benign and malignant nodules were compatible with the morphological differential diagnosis. Conclusion. DS-DECT is highly accurate in determining the benignity and malignancy of thyroid nodules and has a strong potential for clinical promotion to allow for prompt treatment.

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“…It is difficult to achieve a one-to-one correspondence between SDCT and pathology in the selection and evaluation of lymph nodes in clinical practice, which often leads to inconsistent results. Consequently, many studies have sought to obtain relatively stable information by analyzing and extracting the relevant features of primary tumors to predict LNM risk or metastasis ( 17 - 21 ).…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, it is difficult to achieve a one-to-one correspondence between SDCT and pathology in the selection and evaluation of lymph nodes in clinical practice, which often leads to deviations in analysis results. Thus, the prediction of LNM by analyzing the relevant features of the primary tumors instead of the lymph nodes has attracted increasing attention and has proven effective in some malignant tumor lymph node studies ( 17 - 21 ). There are few reports on predicting LNM by exploring the primary cancer foci of NSCLC using SDCT.…”

Section: Introductionmentioning

confidence: 99%

Value of dual-layer spectral detector CT in predicting lymph node metastasis of non-small cell lung cancer

Xie,

Yan,

Liu

et al. 2024

Quant Imaging Med Surg

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Background The accurate assessment of lymph node metastasis (LNM) is crucial for the staging, treatment, and prognosis of lung cancer. In this study, we explored the potential value of dual-layer spectral detector computed tomography (SDCT) quantitative parameters in the prediction of LNM in non-small cell lung cancer (NSCLC). Methods In total, 91 patients presenting with solid solitary pulmonary nodules (8 mm < diameter ≤30 mm) with pathologically confirmed NSCLC (57 without LNM, and 34 with LNM) were enrolled in the study. The patients’ basic clinical data and the SDCT morphological features were analyzed using the chi-square test or Fisher’s exact test. The Mann-Whitney U -test and independent sample t -test were used to analyze the differences in multiple SDCT quantitative parameters between the non-LNM and LNM groups. The diagnostic efficacy of the corresponding parameters in predicting LNM in NSCLC was evaluated by plotting the receiver operating characteristic (ROC) curves. A multivariate logistic regression analysis was conducted to determine the independent predictive factors of LNM in NSCLC. Interobserver agreement was assessed using intraclass correlation coefficients (ICCs) and Bland-Altman plots. Results There were no significant differences between the non-LNM and LNM groups in terms of age, sex, and smoking history. Lesion size and vascular convergence sign differed significantly between the two groups (P<0.05), but there were no significant differences in the six tumor markers. The SDCT quantitative parameters [SAR 40keV , SAR 70keV , Δ 40keV , Δ 70keV , CER 40keV , CER 70keV , NEF 40keV , NEF 70keV , λ, normalized iodine concentration (NIC) and NZ eff ] were significantly higher in the non-LNM group than the LNM group (P<0.05). The ROC analysis showed that CER 40keV , NIC, and CER 70keV had higher diagnostic efficacy than other quantitative parameters in predicting LNM [areas under the curve (AUCs) =0.794, 0.791, and 0.783, respectively]. The multivariate logistic regression analysis showed that size, λ, and NIC were independent predictive factors of LNM. The combination of size, λ, and NIC had the highest diagnostic efficacy (AUC =0.892). The interobserver repeatability of the SDCT quantitative and derived quantitative parameters in the study was good (ICC: 0.801–0.935). Conclusions The SDCT quantitative parameters combined with the clinical data have potential value in predicting LNM in NSCLC. The size + λ + NIC combined parameter model could further improve the prediction efficacy of LNM.

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Parameters of dual-energy CT for the differential diagnosis of thyroid nodules and the indirect prediction of lymph node metastasis in thyroid carcinoma: a retrospective diagnostic study

Cited by 4 publications

References 41 publications

Diagnosis of benign and malignant thyroid nodules by a dual-layer spectral detector CT-based nomogram

Diagnosis of benign and malignant thyroid nodules by a dual-layer spectral detector CT-based nomogram

Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules

Value of dual-layer spectral detector CT in predicting lymph node metastasis of non-small cell lung cancer

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