Department of Radiology, European Institute of Oncology, via Ripamonti 435, 20141, Milan, Italy.
Department of Epidemiology and Biostatistics, via Ramusio,1, 20141, Milan, Italy.
Eur Radiol. 2018 Feb;28(2):760-769. doi: 10.1007/s00330-017-5015-5. Epub 2017 Aug 23.
To evaluate quantification of iodine uptake in metastatic and non-metastatic lymph nodes (LNs) by dual-energy CT (DECT) and to assess if the distribution of iodine within LNs at DECT correlates with the pathological structure.
Ninety LNs from 37 patients (23 with lung and 14 with gynaecological malignancies) were retrospectively selected. Information of LNs sent for statistical analysis included Hounsfield units (HU) at different energy levels; decomposition material densities fat-iodine, iodine-fat, iodine-water, water-iodine. Statistical analysis included evaluation of interobserver variability, material decomposition densities and spatial HU distribution within LNs.
Interobserver agreement was excellent. There was a significant difference in iodine-fat and iodine-water decompositions comparing metastatic and non-metastatic LNs (p < 0.001); fat-iodine and water-iodine did not show significant differences. HU distribution showed a significant gradient from centre to periphery within non-metastatic LNs that was significant up to 20-30% from the centre, whereas metastatic LNs showed a more homogeneous distribution of HU, with no significant gradient.
DECT demonstrated a lower iodine uptake in metastatic compared to non-metastatic LNs. Moreover, the internal iodine distribution showed an evident gradient of iodine distribution from centre to periphery in non-metastatic LNs, and a more homogeneous distribution within metastatic LNs, which corresponded to the pathological structure.
• This study demonstrated a lower iodine uptake in metastatic than non-metastatic LNs. • Internal distribution of HU was different between metastatic and non-metastatic lymph nodes. • The intranodal iodine distribution disclosed a remarkable correlation with the histological LN structure.
通过双能 CT（DECT）评估转移性和非转移性淋巴结（LNs）碘摄取的定量，并评估 DECT 中 LN 内碘的分布是否与病理结构相关。
回顾性选择 37 例患者（23 例肺癌，14 例妇科恶性肿瘤）的 90 个淋巴结。发送进行统计分析的 LN 信息包括不同能级的 Hounsfield 单位（HU）；分解物质密度脂肪碘、碘脂肪、碘水、水碘。统计分析包括评估观察者间的变异性、物质分解密度和 LN 内空间 HU 分布。
观察者间的一致性极好。转移性和非转移性 LNs 之间碘脂肪和碘水的分解有显著差异（p < 0.001）；脂肪碘和水碘没有显著差异。HU 分布在非转移性 LNs 中从中心到外周呈显著梯度，直至中心 20-30%处，而转移性 LNs 中 HU 分布呈更均匀的分布，无显著梯度。
DECT 显示转移性 LNs 比非转移性 LNs 的碘摄取量低。此外，非转移性 LNs 中碘的内部分布从中心到外周呈明显的碘分布梯度，而转移性 LNs 中碘的分布更均匀，与病理结构相对应。
• 本研究表明转移性 LNs 比非转移性 LNs 的碘摄取量低。• HU 的内部分布在转移性和非转移性淋巴结之间不同。• 淋巴结内碘的分布与淋巴结的组织学结构有明显的相关性。
