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Tomography
Volume 4
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10.18383/j.tom.2018.00009
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Article

Dual-Energy CT-Derived Iodine Content and Spectral Attenuation Analysis of Metastatic versus Nonmetastatic Lymph Nodes in Squamous Cell Carcinoma of the Oropharynx

by
Alexandra M. Foust
*,
Rukya M. Ali
,
Xuan V. Nguyen
,
Amit Agrawal
,
Luciano M. Prevedello
,
Eric C. Bourekas
and
Daniel J. Boulter
The Wexner Medical Center, The Ohio State University, Columbus, OH, USA
*
Author to whom correspondence should be addressed.
Tomography 2018, 4(2), 66-71; https://doi.org/10.18383/j.tom.2018.00009
Submission received: 7 March 2018 / Revised: 11 April 2018 / Accepted: 14 May 2018 / Published: 1 June 2018
Versions Notes

Abstract

The presence of a single nodal metastasis has significant prognostic and treatment implications for patients with head and neck cancer. This study aims to investigate whether dual-energy computed tomography (DECT)-derived iodine content and spectral attenuation curve analysis can improve detection of nodal metastasis in oropharyngeal carcinoma. Eight patients with newly diagnosed oropharyngeal squamous cell carcinoma and pathologically proven nodal metastatic disease (n = 13 metastatic nodes; n = 16 nonmetastatic nodes) who underwent contrast-enhanced DECT of the neck were retrospectively evaluated. DECT-derived iodine content (mg/mL) and monoenergetic attenuation values at 40 keV and 100 keV were obtained via circular regions of interest within metastatic and nonmetastatic cervical lymph nodes. Iodine content was significantly lower in metastatic nodes (0.96 ± 0.28 mg/mL) than in nonmetastatic nodes (1.65 ± 0.38 mg/mL; P = .002). Iodine spectral attenuation slope was significantly lower in metastatic nodes (1.33 ± 0.49 mg/mL) than in nonmetastatic nodes (1.91 ± 0.64 mg/mL; P = .015). A nodal iodine threshold of ≤1.3 mg/mL showed a sensitivity of 84.6% and a specificity of 75.0%, with an area under the curve of 0.839, P < .0001. At a threshold value of ≤1.95 for nodal spectral attenuation slope, an optimized specificity of 92.3% and specificity of 50.0% was achieved, with an area under the curve of 0.68 (P = .049). DECT-derived quantitative iodine data and spectral attenuation curves may improve the diagnostic accuracy of computed tomography for nodal metastasis in patients with squamous cell carcinoma of the oropharynx.
Keywords: dual-energy CT; oropharyngeal carcinoma; head and neck dual-energy CT; oropharyngeal carcinoma; head and neck

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MDPI and ACS Style

Foust, A.M.; Ali, R.M.; Nguyen, X.V.; Agrawal, A.; Prevedello, L.M.; Bourekas, E.C.; Boulter, D.J. Dual-Energy CT-Derived Iodine Content and Spectral Attenuation Analysis of Metastatic versus Nonmetastatic Lymph Nodes in Squamous Cell Carcinoma of the Oropharynx. Tomography 2018, 4, 66-71. https://doi.org/10.18383/j.tom.2018.00009

AMA Style

Foust AM, Ali RM, Nguyen XV, Agrawal A, Prevedello LM, Bourekas EC, Boulter DJ. Dual-Energy CT-Derived Iodine Content and Spectral Attenuation Analysis of Metastatic versus Nonmetastatic Lymph Nodes in Squamous Cell Carcinoma of the Oropharynx. Tomography. 2018; 4(2):66-71. https://doi.org/10.18383/j.tom.2018.00009

Chicago/Turabian Style

Foust, Alexandra M., Rukya M. Ali, Xuan V. Nguyen, Amit Agrawal, Luciano M. Prevedello, Eric C. Bourekas, and Daniel J. Boulter. 2018. "Dual-Energy CT-Derived Iodine Content and Spectral Attenuation Analysis of Metastatic versus Nonmetastatic Lymph Nodes in Squamous Cell Carcinoma of the Oropharynx" Tomography 4, no. 2: 66-71. https://doi.org/10.18383/j.tom.2018.00009

APA Style

Foust, A. M., Ali, R. M., Nguyen, X. V., Agrawal, A., Prevedello, L. M., Bourekas, E. C., & Boulter, D. J. (2018). Dual-Energy CT-Derived Iodine Content and Spectral Attenuation Analysis of Metastatic versus Nonmetastatic Lymph Nodes in Squamous Cell Carcinoma of the Oropharynx. Tomography, 4(2), 66-71. https://doi.org/10.18383/j.tom.2018.00009

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