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Huang J, Liu D, Chen J, Wang X, Tang L, Zhang J, Tan Y, Lan X, Yin T, Nickel D, Wu J, Zhang J. Differential diagnosis of thyroid nodules by DCE-MRI based on compressed sensing volumetric interpolated breath-hold examination: A feasibility study. Magn Reson Imaging 2024; 111:138-147. [PMID: 38729225 DOI: 10.1016/j.mri.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
OBJECTIVES To explore the potential and performance of quantitative and semi-quantitative parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on compressed sensing volumetric interpolated breath-hold (CS-VIBE) examination in the differential diagnosis of thyroid nodules. MATERIALS AND METHODS A total of 208 patients with 259 thyroid nodules scheduled for surgery operation were prospectively recruited. All participants underwent routine and DCE-MRI. DCE-MRI quantitative parameters [Ktrans, Kep, Ve], semi-quantitative parameters [wash-in, wash-out, time to peak (TTP), arrival time (AT), peak enhancement intensity (PEI), and initial area under curve in 60 s (iAUC)] and time-intensity curve (TIC) types were analyzed. Differential diagnostic performances were assessed using area under the receiver operating characteristic curve (AUC) and compared with the Delong test. RESULTS Ktrans, Kep, Ve, wash-in, wash-out, PEI and iAUC were statistically significantly different between malignant and benign nodules (P < 0.001). Among these parameters, ROC analysis revealed that Ktrans showed the highest diagnostic performance in the differentiation of benign and malignant nodules, followed by wash-in. ROC analysis also revealed that Ktrans achieved the best diagnostic performance for distinguishing papillary thyroid carcinoma (PTC) from non-PTC, follicular adenoma (FA) from non-FA, nodular goiter (NG) from non-NG, with AUC values of 0.854, 0.895 and 0.609, respectively. Type III curve is frequently observed in benign thyroid nodules, accounting for 77.4% (82/106). While malignant nodules are more common in type II, accounting for 57.5% (88/153). CONCLUSION Thyroid examination using CS-VIBE based DCE-MRI is a feasible, non-invasive method to identify benign and malignant thyroid nodules and pathological types.
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Affiliation(s)
- Junhao Huang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Daihong Liu
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiao Chen
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaoxia Wang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Lin Tang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jing Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Yong Tan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Xiaosong Lan
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Ting Yin
- MR Collaborations, Siemens Healthineers Ltd., Chengdu, China
| | - Dominik Nickel
- MR Applications Predevelopment, Siemens Healthcare GmbH, Erlangen, Germany
| | - Jian Wu
- Head and Neck Cancer Center, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China
| | - Jiuquan Zhang
- Department of Radiology, Chongqing University Cancer Hospital, School of Medicine, Chongqing University, Chongqing, China.
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Ota T, Onishi H, Fukui H, Tsuboyama T, Nakamoto A, Honda T, Matsumoto S, Tatsumi M, Tomiyama N. Prediction models for differentiating benign from malignant liver lesions based on multiparametric dual-energy non-contrast CT. Eur Radiol 2024:10.1007/s00330-024-11024-8. [PMID: 39186105 DOI: 10.1007/s00330-024-11024-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 07/02/2024] [Accepted: 07/17/2024] [Indexed: 08/27/2024]
Abstract
OBJECTIVES To create prediction models (PMs) for distinguishing between benign and malignant liver lesions using quantitative data from dual-energy CT (DECT) without contrast agents. MATERIALS AND METHODS This retrospective study included patients with liver lesions who underwent DECT, including non-contrast-enhanced scans. Benign lesions included hepatic hemangioma, whereas malignant lesions included hepatocellular carcinoma, metastatic liver cancer, and intrahepatic cholangiocellular carcinoma. Patients were divided into derivation and validation groups. In the derivation group, two radiologists calculated ten multiparametric data using univariate and multivariate logistic regression to generate PMs. In the validation group, two additional radiologists measured the parameters to assess the diagnostic performance of PMs. RESULTS The study included 121 consecutive patients (mean age 67.4 ± 13.8 years, 80 males), with 97 in the derivation group (25 benign and 72 malignant) and 24 in the validation group (7 benign and 17 malignant). Oversampling increased the benign lesion sample to 75, equalizing the malignant group for building PMs. All parameters were statistically significant in univariate analysis (all p < 0.05), leading to the creation of five PMs in multivariate analysis. The area under the curve for the five PMs of two observers was as follows: PM1 (slope K, blood) = 0.76, 0.74; PM2 (slope K, fat) = 0.55, 0.51; PM3 (effective-Z difference, blood) = 0.75, 0.72; PM4 (slope K, blood, fat) = 0.82, 0.78; and PM5 (slope K, effective-Z difference, blood) = 0.90, 0.87. PM5 yielded the best diagnostic performance. CONCLUSION Multiparametric non-contrast-enhanced DECT is a highly effective method for distinguishing between liver lesions. CLINICAL RELEVANCE STATEMENT The utilization of non-contrast-enhanced DECT is extremely useful for distinguishing between benign and malignant liver lesions. This approach enables physicians to plan better treatment strategies, alleviating concerns associated with contrast allergy, contrast-induced nephropathy, radiation exposure, and excessive medical expenses. KEY POINTS Distinguishing benign from malignant liver lesions with non-contrast-enhanced CT would be desirable. This model, incorporating slope K, effective Z, and blood quantification, distinguished benign from malignant liver lesions. Non-contrast-enhanced DECT has benefits, particularly in patients with an iodine allergy, renal failure, or asthma.
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Affiliation(s)
- Takashi Ota
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | - Hiromitsu Onishi
- Department of Medical Physics and Engineering, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Hideyuki Fukui
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Takahiro Tsuboyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Nakamoto
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Toru Honda
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Shohei Matsumoto
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mitsuaki Tatsumi
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Noriyuki Tomiyama
- Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan
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Zou Y, Shi Y, Bi H, Tan J, Guo Q, Qin Y, Lu X, Ma X, Yang S, Liu J. A nomogram for risk stratification of central cervical lymph node metastasis in patients with papillary thyroid carcinoma. Quant Imaging Med Surg 2024; 14:5084-5098. [PMID: 39022275 PMCID: PMC11250316 DOI: 10.21037/qims-24-284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/13/2024] [Indexed: 07/20/2024]
Abstract
Background Whether to perform prophylactic central lymph node dissection for cN0 papillary thyroid carcinoma (PTC) patients is still controversial. This retrospective study aimed to develop and validate a nomogram based on ultrasound and dual-energy computed tomography (DECT) for the risk stratification of central lymph node metastasis (CLNM) in patients with PTC. Methods A total of 525 patients from 2017 to 2019 [Tianjin First Central Hospital (Hospital A)] were retrospectively analyzed to form the training cohort and to conduct internal validation. Another group of 204 patients in 2020 (Hospital A) formed the temporal validation cohort. A total of 107 patients in 2020 [Binzhou Medical University Hospital (Hospital B)] formed the geographic validation cohort, which was a retrospective cohort study. The area under the curve (AUC), calibration curve, and decision curve were used to evaluate the performance of the nomogram. The locally weighted regression curve was used for risk stratification. Results Diameter, taller-than-wide, calcification, capsular invasion, and iodine concentration in the arterial and venous phases were independent risk predictors of CLNM. The AUC of the nomogram was 0.922 (95% confidence interval: 0.895-0.943) in the training cohort. Two external validation cohorts demonstrated the good performance of the nomogram in predicting CLNM, with AUCs of 0.912 and 0.861. The significantly improved net reclassification index and integrated discriminatory improvement index indicated that DECT was a powerful supplement to ultrasound for predicting CLNM. The risk stratification system divided all patients into low-risk (0-50 points), intermediate-risk (51-100 points), and high-risk groups (>100 points). Conclusions The nomogram and risk stratification system estimated the utility of CLNM to guide individualized treatment of patients with PTC.
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Affiliation(s)
- Ying Zou
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Yan Shi
- Department of Ultrasonography, Weihai Municipal Hospital, Weihai, China
- Department of Ultrasonography, Binzhou Medical University Hospital, Binzhou, China
| | - Hai Bi
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Junyan Tan
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Qingwei Guo
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yi Qin
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Xiudi Lu
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Department of Radiology, Tianjin First Central Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Xiaojing Ma
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Shouhong Yang
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Jihua Liu
- Department of Radiology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- Department of Radiology, National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
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Yel I, Koch V, Gruenewald LD, Mahmoudi S, Alizadeh LS, Goekduman A, Eichler K, Vogl TJ, Dimitrova M, Booz C. Advancing Differentiation of Hepatic Metastases in Malignant Melanoma through Dual-Energy Computed Tomography Rho/Z Maps. Diagnostics (Basel) 2024; 14:742. [PMID: 38611654 PMCID: PMC11012221 DOI: 10.3390/diagnostics14070742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES The aim of this study is to evaluate the diagnostic accuracy of dual-energy computed tomography (DECT)-based Rho/Z maps in differentiating between metastases and benign liver lesions in patients diagnosed with malignant melanoma compared to conventional CT value measurements. METHODS This retrospective study included 73 patients (mean age, 70 ± 13 years; 43 m/30 w) suffering from malignant melanoma who had undergone third-generation DECT as part of tumor staging between December 2017 and December 2021. For this study, we measured Rho (electron density) and Z (effective atomic number) values as well as Hounsfield units (HUs) in hypodense liver lesions. Values were compared, and diagnostic accuracy for differentiation was computed using receiver operating characteristic (ROC) curve analyses. Additional performed MRI or biopsies served as a standard of reference. RESULTS A total of 136 lesions (51 metastases, 71 cysts, and 14 hemangiomas) in contrast-enhanced DECT images were evaluated. The most notable discrepancy (p < 0.001) between measured values and the highest diagnostic accuracy for distinguishing melanoma metastases from benign cysts was observed for the Z (0.992; 95% CI, 0.956-1) parameters, followed by Rho (0.908; 95% CI, 0.842-0.953) and finally HU120kV (0.829; 95% CI, 0.751-0.891). Conversely, when discriminating between liver metastases and hemangiomas, the HU120kV parameters showed the most significant difference (p < 0.001) and yielded the highest values for diagnostic accuracy (0.859; 95% CI, 0.740-0.937), followed by the Z parameters (0.790; 95% CI, 0.681-0.876) and finally the Rho values (0.621; 95% CI, 0.501-0.730). CONCLUSIONS Rho and Z measurements derived from DECT allow for improved differentiation of liver metastases and benign liver cysts in patients with malignant melanoma compared to conventional CT value measurements. In contrast, in differentiation between liver hemangiomas and metastases, Rho/Z maps show inferior diagnostic accuracy. Therefore, differentiation between these two lesions remains a challenge for CT imaging.
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Yi R, Li T, Xie G, Li K. Diagnosis of benign and malignant thyroid nodules by a dual-layer spectral detector CT-based nomogram. Front Oncol 2023; 13:1132817. [PMID: 37007108 PMCID: PMC10065147 DOI: 10.3389/fonc.2023.1132817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/06/2023] [Indexed: 03/19/2023] Open
Abstract
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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Affiliation(s)
- Rongqi Yi
- Department of Radiology, Chongqing General Hospital, Chongqing, China
| | - Ting Li
- Department of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Gang Xie
- Department of Medical Imaging, North Sichuan Medical College, Nanchong, Sichuan, China
| | - Kang Li
- Department of Radiology, Chongqing General Hospital, Chongqing, China
- *Correspondence: Kang Li,
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Song Z, Li Q, Zhang D, Li X, Yu J, Liu Q, Li Z, Huang J, Zhang X, Tang Z. Nomogram based on spectral CT quantitative parameters and typical radiological features for distinguishing benign from malignant thyroid micro-nodules. Cancer Imaging 2023; 23:13. [PMID: 36703218 PMCID: PMC9878766 DOI: 10.1186/s40644-023-00525-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 01/06/2023] [Indexed: 01/27/2023] Open
Abstract
PURPOSE To analyse the predictive effect of a nomogram combining dual-layer spectral computed tomography (DSCT) quantitative parameters with typical radiological features in distinguishing benign micro-nodule from thyroid microcarcinoma (TMC). METHODS Data from 342 instances with thyroid micro-nodules (≤1 cm) who underwent DSCT (benign group: n = 170; malignant group: n = 172) were reviewed. Typical radiological features including micro-calcification and enhanced blurring, and DSCT quantitative parameters including attenuation on virtual monoenergetic images (40 keV, 70 keV and 100 keV), the slope of the spectral HU curve (λHU), normalized iodine concentration (NIC), and normalized effective atomic number (NZeff) in the arterial phase (AP) and venous phase (VP), were measured and compared between the benign and malignant groups. The receiver operating characteristic (ROC) curve was used to assess the diagnostic performance of significant quantitative DSCT parameters or the models combining DSCT parameters respectively and typical radiological features based on multivariate logistic regression (LR) analysis. A nomogram was developed using predictors with the highest diagnostic performance in the above model, as determined by multivariate LR analysis. RESULTS The DSCT parameter APλHU showed the greatest diagnostic efficiency in identifying patients with TMC, with an area under the ROC curve (AUC) of 0.829, a sensitivity and specificity of 0.738 and 0.753, respectively. Then, APλHU was combined with the two radiological features to construct the DSCT-Radiological nomogram, which had an AUC of 0.858, a sensitivity of 0.791 and a specificity of 0.800. The calibration curve of the nomogram demonstrated that the prediction result was in good agreement with the actual observation. The decision curve revealed that the nomogram can result in a greater net benefit than the all/none-intervention strategy for all threshold probabilities. CONCLUSION As a valid and visual noninvasive prediction tool, the DSCT-Radiological nomogram incorporating DSCT quantitative parameters and radiological features shows favourable predictive efficiency for identifying benign and malignant thyroid micro-nodules.
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Affiliation(s)
- Zuhua Song
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Qian Li
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Dan Zhang
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Xiaojiao Li
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Jiayi Yu
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Qian Liu
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Zongwen Li
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Jie Huang
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
| | - Xiaodi Zhang
- Philips Healthcare, Chengdu branch, Chengdu, China
| | - Zhuoyue Tang
- Department of Radiology, Chongqing General Hospital, No.118, Xingguang Avenue, Liangjiang New Area, Chongqing, 401147 China
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Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2257304. [PMID: 36034942 PMCID: PMC9402342 DOI: 10.1155/2022/2257304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/08/2022] [Accepted: 07/08/2022] [Indexed: 11/25/2022]
Abstract
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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Li F, Huang F, Liu C, Pan D, Tang X, Wen Y, Chen Z, Qin Y, Chen J. 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. Gland Surg 2022; 11:913-926. [PMID: 35694089 PMCID: PMC9177276 DOI: 10.21037/gs-22-262] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/18/2022] [Indexed: 08/29/2023]
Abstract
BACKGROUND To further investigate the differential diagnosis of thyroid nodules using dual-energy computed tomography (DECT) and explore the relationship between DECT parameters and lymph node metastasis in thyroid carcinoma for clinical practice, especially difficult diagnosis by routine imaging examination. METHODS A total of 150 patients with thyroid nodules who underwent preoperative DECT and Thyroid Imaging Report and Data System (TIRADS) classification were enrolled in this study, including 96 patients with malignant tumors and 54 with benign tumors. The DECT parameters were got form regions of interest (ROI) by an experienced radiologist team and thyroid nodules and lymph node status of all patients were identified by cytology and histopathology. Statistical analyses were performed using Student's t-test, Chi-squared test, and receiver operating characteristic (ROC) curves. RESULTS In the differential diagnosis of benign and malignant thyroid nodules, the optimal iodine concentration (IC) and normalized iodine concentration (NIC) cut-off values were ICa (2.835 mg/mL), NIC1a (0.690), and their corresponding area under the curve (AUC) were 0.940, 0.954 respectively; meantime, the optimal computed tomography (CT) value and slope of the spectral Hounsfield unit curve (λHU) cut-off values were 70 keVa (125.05 HU) and λHU2a (1.405), and their corresponding AUC were 0.955, 0.941 respectively. For lymph node status (with or without lymph node metastasis), the optimal IC and NIC thresholds were ICa (1.715 mg/mL) and NIC2a (0.155), and their corresponding AUC were 0.717, 0.720 respectively; meanwhile, the optimal CT value and λHU thresholds were 70 keVv (89.635 HU) and λHU2v (1.185), and their corresponding AUC were 0.729, 0.641 respectively. CONCLUSIONS Base on our study, we think DECT is useful in differentiating malignant from benign thyroid nodules, which has potential value in the indirect prediction of lymph node metastasis in thyroid carcinoma.
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Affiliation(s)
- Fu Li
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Fuling Huang
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Chenmin Liu
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Denghua Pan
- Department of Ultrasonography, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xiaoqi Tang
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yan Wen
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Zhibai Chen
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yuhong Qin
- Department of Radiology, First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Junqiang Chen
- Department of Gastrointestinal Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning, China
- The Guangxi Key Laboratory of Enhanced Recovery after Surgery for Gastrointestinal Cancer, Nanning, China
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