Dual-energy CT in the differentiation of stage T1 nasopharyngeal carcinoma and lymphoid hyperplasia.

PURPOSE

To explore the value of dual-energy CT for the differentiation between stage T1 nasopharyngeal carcinoma (NPC) and lymphoid hyperplasia (LH).

METHOD

Patients with histopathological proven nasopharyngeal lesions (stage T1 NPCs, n = 30; LHs, n = 47) who underwent dual-energy CT were enrolled in this retrospective study. Quantitative parameters derived from dual-energy CT were measured. Statistical analyses were performed using the independent sample t-test, Wilcoxon rank sum test, and receiver operating characteristic curve (ROC) analysis.

RESULTS

There was significantly higher iodine concentration (IC), normalized iodine concentration (NIC, to internal jugular vein) in NPC compared with LH (p < 0.001). The effective atomic number (Z) was significantly higher in NPC than that in LH (p <  0.001). The virtual monochromatic images (VMIs) at 50 keV-110 keV (20 keV-interval) of NPC were all significantly higher than those of LH (all p <0.001). The slope (k) value of spectral attenuation curve was also significantly higher in NPC than LH (p <  0.001). There was no significant difference in virtual noncontrast (VNC) and 130 keV-190 keV (20 keV-interval) between the NPC and LH. For discriminating NPC from LH, the area under curve (AUC) using 70 keV was the highest in all single parameter (AUC, 0.92; sensitivity, 80.00 %; specificity, 91.49 %). Combined multiple parameters (IC, NIC, Z, 50 keV, 70 keV, 90 keV, slope (k)) by performing multivariate logistic regression model significantly improve the diagnostic capability in differentiating these two entities, with AUC, sensitivity, and specificity values of 0.99, 93.33 %, 97.87 %, respectively.

CONCLUSIONS

Dual-energy CT can be helpful for the differentiation between NPC and LH lesions.