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Usefulness of dual-layer spectral CT in follow-up examinations: diagnosing recurrent squamous cell carcinomas in the head and neck

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the usefulness of dual-energy analyses using dual-layer spectral CT (DLSCT) for diagnosing recurrent lesions of head and neck squamous cell carcinoma (HNSCC).

Materials and methods

The study population comprised 62 patients with a history of HNSCC. Attenuation values on conventional 120-kVp images and 40-keV virtual monochromatic images (VMIs) and iodine concentration (IC) were compared between recurrent lesions and post-treatment changes or non-recurrent nodes using the Mann–Whitney U test. Receiver-operating characteristic (ROC) analysis was used to assess the ability of attenuation values and IC to diagnose recurrent lesions.

Results

Attenuation values for 120-kVp and 40-keV images and IC of local recurrent lesions were significantly higher than those of post-treatment changes (p < 0.001), whereas recurrent nodes showed significantly lower attenuation values for both 120 kVp and 40 keV and IC than non-recurrent nodes (p < 0.001). Area under the ROC curves for 120-kVp images, 40-keV images, and IC to diagnose local recurrences were 0.912, 0.992, and 0.984, respectively, and those to diagnose recurrent nodes were 0.819, 0.922, and 0.934, respectively.

Conclusions

Dual-energy images using DLSCT, particularly 40-keV VMIs and IC, may help in diagnosing recurrent lesions of HNSCC.

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Abbreviations

HNSCC:

Head and neck squamous cell carcinoma

NIRADS:

Head and neck imaging reporting and data system

VMI:

Virtual monochromatic image

IC:

Iodine concentration

HU:

Hounsfield unit

DLSCT:

Dual-layer spectral CT

ROI:

Region-of-interest

SNR:

Signal-to-noise ratio

CNR:

Contrast-to-noise ratio

ICC:

Intraclass correlation coefficient

ROC:

Receiver-operating characteristic

AUCs:

Areas under the ROC curves

SD:

Standard deviation

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Authors and Affiliations

  1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Koji Takumi, Hiroto Hakamada, Hiroaki Nagano, Yoshihiko Fukukura, Yuichi Kumagae & Takashi Yoshiura

  2. Departments of Radiology, Radiation Oncology, Otolaryngology-Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, 02118, USA

    Osamu Sakai

Authors
  1. Koji Takumi
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  2. Hiroto Hakamada
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  3. Hiroaki Nagano
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  4. Yoshihiko Fukukura
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  5. Yuichi Kumagae
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  7. Takashi Yoshiura
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Corresponding author

Correspondence to Koji Takumi.

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Informed consent

Institutional ethics review board approval was obtained, and informed consent was waived for this retrospective study.

Ethical statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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The authors declare that they have no conflict of interest.

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Online supplementary figures

Bland-Altman plots of each quantitative parameter (local CT attenuation value on 120 kVp (a) and on 40 keV (b), local iodine concentration (c), lymph node CT attenuation value on 120 kVp (d) and on 40 keV (e), lymph node iodine concentration (f), local signal-to-noise ratio on 120 kVp (g) and on 40 keV (h), lymph node signal-to-noise ratio on 120 kVp (i) and on 40 keV (j), and recurrent lesion contrast-to-noise on 120 kVp (k) and on 40 keV (l)), illustrating mean differences and 95% limits of agreement between Observers 1 and 2 (TIF 1541 kb)

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Takumi, K., Hakamada, H., Nagano, H. et al. Usefulness of dual-layer spectral CT in follow-up examinations: diagnosing recurrent squamous cell carcinomas in the head and neck. Jpn J Radiol 39, 324–332 (2021). https://doi.org/10.1007/s11604-020-01071-8

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  • DOI: https://doi.org/10.1007/s11604-020-01071-8

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