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

Authors
  • Takumi, Koji1
  • Hakamada, Hiroto1
  • Nagano, Hiroaki1
  • Fukukura, Yoshihiko1
  • Kumagae, Yuichi1
  • Sakai, Osamu2
  • Yoshiura, Takashi1
  • 1 Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan , Kagoshima (Japan)
  • 2 Boston University School of Medicine, Boston, MA, 02118, USA , Boston (United States)
Type
Published Article
Journal
Japanese Journal of Radiology
Publisher
Springer Singapore
Publication Date
Nov 19, 2020
Volume
39
Issue
4
Pages
324–332
Identifiers
DOI: 10.1007/s11604-020-01071-8
Source
Springer Nature
Keywords
License
Yellow

Abstract

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

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