Lee Younghen
Korea University College of Medicine, Ansan Hospital, Department of Radiology, Ansan, South Korea.
Diagn Interv Radiol. 2025 Apr 28;31(3):226-233. doi: 10.4274/dir.2025.243132. Epub 2025 Mar 18.
To investigate the relationship between intrathyroidal iodine concentration (IC) (mg I/mL) and thyroid hormonal status or pathologic diagnosis with the use of dual-energy computed tomography (DECT).
We retrospectively included patients who underwent neck CT examination between September 2016 and August 2021 using a dual-layer DECT scanner (120 kilovolt peak) for preoperative thyroid imaging. We performed volumetric IC measurements at the thyroid parenchyma on the additional iodine map generated from non-contrast images. We then compared the mean IC of thyroid parenchyma based on thyroid hormonal status (hypothyroid, euthyroid, and hyperthyroid) and diffuse thyroid disease (DTD). Additionally, we determined the accuracy of iodine quantification with our site-specific DECT acquisition protocol using a Gammex phantom containing seven iodine inserts with different ICs ranging from 2 to 20 mgI/mL.
Among the 578 patients (M:F: 87:491, age: 48.6 ± 11.7 years) who were finally selected, the mean thyroid parenchymal ICs was the lowest in the hyperthyroid group, followed by the hypothyroid group, and then the euthyroid group (0.68 ± 0.37, n = 44 vs. 1.13 ± 0.42, n = 61 vs. 1.32 ± 0.43, n = 473, < 0.01, respectively). In the patients with euthyroidism, the mean parenchymal IC was already lower in the patients with pathologically proven DTD than in those without DTD (1.22 ± 0.44 mgI/mL vs. 1.45 ± 0.37 mgI/mL, < 0.01). Based on the phantom study, the median percentage deviations from the expected values were 5.1% for ICs of 2-20 mgI/mL.
DECT-based IC quantification could be a potentially useful method for identifying patients with thyroid hormone dysfunction or DTD without the use of contrast media.
Without the need for intravenous administration, DECT-based intrathyroidal IC quantification provides potentially valuable information from the non-contrast CT image of the thyroid parenchyma.
利用双能计算机断层扫描（DECT）研究甲状腺内碘浓度（IC）（毫克碘/毫升）与甲状腺激素状态或病理诊断之间的关系。
我们回顾性纳入了2016年9月至2021年8月期间使用双层DECT扫描仪（120千伏峰值）进行术前甲状腺成像而接受颈部CT检查的患者。我们在由非增强图像生成的额外碘图上对甲状腺实质进行容积IC测量。然后，我们根据甲状腺激素状态（甲状腺功能减退、甲状腺功能正常和甲状腺功能亢进）和弥漫性甲状腺疾病（DTD）比较甲状腺实质的平均IC。此外，我们使用含有七个碘插入物的Gammex体模，其IC范围为2至20毫克碘/毫升，通过我们特定部位的DECT采集方案确定碘定量的准确性。
在最终入选的578例患者（男:女 = 87:491，年龄: 48.6 ± 11.7岁）中，甲状腺功能亢进组的甲状腺实质平均IC最低，其次是甲状腺功能减退组，然后是甲状腺功能正常组（分别为0.68 ± 0.37，n = 44；1.13 ± 0.42，n = 61；1.32 ± 0.43，n = 473，P < 0.01）。在甲状腺功能正常的患者中，病理证实为DTD的患者的实质平均IC已经低于无DTD的患者（1.22 ± 0.44毫克碘/毫升对1.45 ± 0.37毫克碘/毫升，P < 0.01）。基于体模研究，对于2至20毫克碘/毫升的IC，与预期值的中位数百分比偏差为5.1%。
基于DECT的IC定量可能是一种在不使用造影剂的情况下识别甲状腺激素功能障碍或DTD患者的潜在有用方法。
无需静脉给药，基于DECT的甲状腺内IC定量可从甲状腺实质的非增强CT图像中提供潜在有价值的信息。
