Zopfs D, Lennartz S, Große Hokamp N, Rau K, Zaeske C, Laukamp K R, Houbois C, Luers J C, Maintz D, Puesken M
University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany.
University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute for Diagnostic and Interventional Radiology, Cologne, Germany; Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114, USA.
Clin Radiol. 2022 Jun;77(6):e425-e433. doi: 10.1016/j.crad.2022.02.013. Epub 2022 Mar 26.
To evaluate the diagnostic value of spectral detector computed tomography (SDCT)-derived iodine overlay maps and low-energy virtual mono-energetic images (VMI) for the initial locoregional assessment of primary, therapy-naive head and neck cancer.
Fifty-six patients with histologically confirmed untreated squamous cell carcinoma of the head and neck who underwent SDCT of the neck for staging purposes were included in this retrospective study. Attenuation, image noise as well as signal- and contrast-to-noise ratios (S-/CNR) in VMI were obtained from region of interest (ROI)-based measurements in the tumour and important anatomical landmarks (sternocleidomastoid muscle, subcutaneous fat, thyroid gland, submandibular gland, carotid artery, and jugular vein). Tumour conspicuity and delineation, as well as subjective image quality, were rated for conventional images, VMI, and iodine overlay maps using five-point Likert scales.
The CNR of the tumour versus the floor of the mouth and the CNR of the tumour versus the sternocleidomastoid muscle was significantly higher in VMI in comparison to conventional images (10.0 ± 7.3 versus 3.8 ± 3.3 and 11.3 ± 7.6 versus 3.6 ± 2.8; p<0.05 each). This was supported by qualitative results, as tumour conspicuity and delineation received superior ratings in iodine overlay maps and VMI compared to conventional images (5 [3-5] and 5 [4-5] versus 3 [2-5]; 5 [2-5] and 5 [3-5] versus 3 [2-4], respectively, all p<0.05). VMI yielded the highest score among all included image reconstructions for overall image quality (p<0.05 all).
Iodine overlay maps and low-energy VMI derived from SDCT improve initial assessment of primary squamous cell carcinoma of the head and neck compared to conventional images.
评估光谱探测器计算机断层扫描（SDCT）衍生的碘叠加图和低能量虚拟单能图像（VMI）对原发性、未经治疗的头颈癌进行初始局部区域评估的诊断价值。
本回顾性研究纳入了56例经组织学证实的未经治疗的头颈鳞状细胞癌患者，这些患者因分期目的接受了颈部SDCT检查。通过基于感兴趣区域（ROI）的测量，在肿瘤以及重要解剖标志（胸锁乳突肌、皮下脂肪、甲状腺、颌下腺、颈动脉和颈静脉）中获取VMI的衰减、图像噪声以及信号与对比度噪声比（S-/CNR）。使用五点李克特量表对传统图像、VMI和碘叠加图的肿瘤清晰度和轮廓以及主观图像质量进行评分。
与传统图像相比，VMI中肿瘤与口腔底部的CNR以及肿瘤与胸锁乳突肌的CNR显著更高（分别为10.0±7.3对3.8±3.3以及11.3±7.6对3.6±2.8；均p<0.05）。定性结果支持了这一点，因为与传统图像相比，碘叠加图和VMI中的肿瘤清晰度和轮廓评分更高（分别为5[3 - 5]和5[4 - 5]对3[2 - 5]；5[2 - 5]和5[3 - 5]对3[2 - 4]，均p<0.05）。在所有纳入的图像重建中，VMI的整体图像质量得分最高（均p<0.05）。
与传统图像相比，SDCT衍生的碘叠加图和低能量VMI改善了对头颈原发性鳞状细胞癌的初始评估。
