Suntharalingam Saravanabavaan, Stenzel Elena, Wetter Axel, Guberina Nika, Umutlu Lale, Schlosser Thomas, Nassenstein Kai
Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
Acta Radiol. 2019 May;60(5):586-592. doi: 10.1177/0284185118788896. Epub 2018 Aug 8.
Dual-energy CT (DECT) provides additional image datasets which enable improved tumor delineation or reduction of beam hardening artifacts in patients with head and neck squamous cell carcinoma (SCC).
To assess radiation dose and image quality of third-generation DECT of the head and neck in comparison to single-energy CT (SECT).
Thirty patients with SCC who underwent both SECT (reference tube voltage 120 kVp) and DECT (80/150 Sn kVp) of the head and neck region for staging were retrospectively selected. Attenuation measurements of the sternomastoid muscle, internal jugular vein, submandibular gland and tongue were compared. Image noise was assessed at five anatomic levels. Subjective image quality was evaluated by two radiologists in consensus.
CTDI was 55% lower with DECT (4.2 vs. 9.3 mGy; P = 0.002). Median image noise was equal or lower in DECT at all levels (nasopharynx: 3.9 vs. 5.8, P < 0.0001; floor of mouth: 3.6 vs. 4.5, P = 0.0002; arytenoids: 3.6 vs. 3.1, P = 0.096; lower thyroid: 4.4 vs. 5.7, P = 0.002; arch of aorta: 5.6 vs. 6.5, P = 0.001). Attenuation was significantly lower in DECT ( P < 0.05). Subjective image analysis revealed that DECT is equal or superior to SECT with regard to overall image quality (nasopharynx: 5 vs. 5, P = 1; floor of mouth: 5 vs. 5, P = 0.0041; arytenoids: 5 vs. 5, P = 0.6; lower thyroid: 5 vs. 3, P < 0.0001; arch of aorta: 5 vs. 4, P < 0.0001).
Head and neck imaging with third-generation DECT can reduce radiation dose by half compared to SECT, while maintaining excellent image quality.
双能CT（DECT）可提供额外的图像数据集，有助于改善头颈部鳞状细胞癌（SCC）患者的肿瘤轮廓描绘或减少线束硬化伪影。
与单能CT（SECT）相比，评估头颈部第三代DECT的辐射剂量和图像质量。
回顾性选取30例因分期而行头颈部SECT（参考管电压120 kVp）和DECT（80/150 Sn kVp）检查的SCC患者。比较胸锁乳突肌、颈内静脉、下颌下腺和舌的衰减测量值。在五个解剖层面评估图像噪声。由两名放射科医生共同评估主观图像质量。
DECT的CTDI降低了55%（4.2对9.3 mGy；P = 0.002）。在所有层面，DECT的图像噪声中位数相等或更低（鼻咽部：3.9对5.8，P < 0.0001；口腔底部：3.6对4.5，P = 0.0002；杓状软骨：3.6对3.1，P = 0.096；甲状腺下部：4.4对5.7，P = 0.002；主动脉弓：5.6对6.5，P = 0.001）。DECT的衰减显著更低（P < 0.05）。主观图像分析显示，在总体图像质量方面，DECT等于或优于SECT（鼻咽部：5对5，P = 1；口腔底部：5对5，P = 0.0041；杓状软骨：5对5，P = 0.6；甲状腺下部：5对3，P < 0.0001；主动脉弓：5对4，P < 0.0001）。
与SECT相比，使用第三代DECT进行头颈部成像可将辐射剂量减半，同时保持优异的图像质量。
