Abstract:Compared with linearly blended images, virtual monoenergetic reconstructions of DECT data at 60 keV significantly improve lesion enhancement and CNR, subjective overall image quality, and tumor delineation of head and neck squamous cell carcinoma.
“…Recently, emerging dual-energy CT techniques have been investigated for head and neck cancer imaging with the potential for improved tumor visualization and characterization. [14][15][16][17][18][19][20][21] In particular, techniques using iodine overlay (IO) images were found useful for distinguishing iodine-enhanced tumors from nonossified cartilage 11,14,19,22 and for having higher specificity than conventional CT, without a deterioration of sensitivity, in particular for the evaluation of thyroid cartilage invasion. 14 Furthermore, interobserver agreement is usually poor for conventional CT and was found to be higher for dual-energy CT. 14,23 These new dualenergy CT techniques have prompted re-evaluations of the diagnostic performance of CT compared with MR imaging in diagnostic fields where MR imaging has been routinely used.…”
“…Recently, emerging dual-energy CT techniques have been investigated for head and neck cancer imaging with the potential for improved tumor visualization and characterization. [14][15][16][17][18][19][20][21] In particular, techniques using iodine overlay (IO) images were found useful for distinguishing iodine-enhanced tumors from nonossified cartilage 11,14,19,22 and for having higher specificity than conventional CT, without a deterioration of sensitivity, in particular for the evaluation of thyroid cartilage invasion. 14 Furthermore, interobserver agreement is usually poor for conventional CT and was found to be higher for dual-energy CT. 14,23 These new dualenergy CT techniques have prompted re-evaluations of the diagnostic performance of CT compared with MR imaging in diagnostic fields where MR imaging has been routinely used.…”
“…VMI can also be applied for better tumor delineation in head and neck oncology [18] [45••]. Because of higher attenuation of iodine in lower-keV VMI, superior tumor contrast by iodine uptake can be achieved; this, however, can occur at the cost of higher image noise (Figs.…”
Section: Applicationsmentioning
confidence: 99%
“…Objective enhancement of SCC lesion peaked in 40-keV, followed by 60-keV reconstructions, but 60-keV VMIs were subjectively more favorable in image quality and tumor delineation. Compared with linearly blended images, with a WA 0.3, VMI of 60 keV seemed to be superior in tumor attenuation and CNR [18]. Fig.…”
Purpose of ReviewTo explain the technique of Dual-energy CT (DECT) and highlight its applications and advantages in head and neck radiology.Recent FindingsUsing DECT, additional datasets can be created next to conventional images. In head and neck radiology, three material decomposition algorithms can be used for improved lesion detection and delineation of the tumor. Iodine concentration measurements can aid in differentiating malignant from nonmalignant lymph nodes and benign posttreatment changes from tumor recurrence. Virtual non-calcium images can be used for detection of bone marrow edema. Virtual mono-energetic imaging can be useful for improved iodine conspicuity at lower keV and for reduction of metallic artifacts and increase in signal-to-noise ratio at higher keV.SummaryDECT and its additional reconstructions can play an important role in head and neck cancer patients, from initial diagnosis and staging, to therapy planning, evaluation of treatment response and follow-up. Moreover, it can be helpful in imaging of infections and inflammation and parathyroid imaging as supplementary reconstructions can be obtained at lower or equal radiation dose compared with conventional single energy scanning.
“…Since the introduction of clinical DECT scanners in 2006 [ 1 , 2 , 3 ], there has been increasing literature on potential applications of DECT in all major subspecialties in radiology [ 4 , 5 , 6 , 7 ]. In particular, there is increasing evidence supporting the advantages of using DECT for evaluating head and neck pathology, with specific applications for head and neck squamous cell carcinoma (HNSCC) [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 ].…”
There is an increasing body of evidence establishing the advantages of dual-energy CT (DECT) for evaluation of head and neck squamous cell carcinoma (HNSCC). Focusing on a single-source DECT system with fast kVp switching, we will review the principles behind DECT and associated post-processing steps that make this technology especially suitable for HNSCC evaluation and staging. The article will review current applications of DECT for evaluation of HNSCC including use of different reconstructions to improve tumor conspicuity, tumor-normal soft tissue interface, accuracy of invasion of critical structures such as thyroid cartilage, and reduce dental artifact. We will provide a practical approach for DECT implementation into routine clinical use and a multi-parametric approach for scan interpretation based on the experience at our institution. The article will conclude with a brief overview of potential future applications of the technique.
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