Multiparametric dual-energy CT for distinguishing nasopharyngeal carcinoma from nasopharyngeal lymphoma

•40 keV VMI (+) yielded the optimal image quality for visualization of NPC and NPL.•Quantitative parameters derived from DECT could differentiate NPC from NPL.•Combined DECT quantitative parameters improved the diagnostic performance. To determine the optimal kiloelectron volt of noise-optimized vir...

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Bibliographic Details
Published in:European journal of radiology 2021-03, Vol.136, p.109532-109532, Article 109532
Main Authors: Shen, Hesong, Yuan, Xiaoqian, Liu, Daihong, Huang, Yuanying, Wang, Yu, Jiang, Shixi, Zhang, Jiuquan
Format: Article
Language:English
Subjects:
Algorithms
Dual-energy scanned projection
Humans
Lymphoma
Lymphoma - diagnostic imaging
Nasopharyngeal carcinoma
Nasopharyngeal Carcinoma - diagnostic imaging
Nasopharyngeal Neoplasms - diagnostic imaging
Radiography
Radiography, Dual-Energy Scanned Projection
Retrospective Studies
Signal-To-Noise Ratio
Tomography, X-Ray Computed
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Summary:•40 keV VMI (+) yielded the optimal image quality for visualization of NPC and NPL.•Quantitative parameters derived from DECT could differentiate NPC from NPL.•Combined DECT quantitative parameters improved the diagnostic performance. To determine the optimal kiloelectron volt of noise-optimized virtual monoenergetic images [VMI (+)] for visualization of nasopharyngeal carcinoma (NPC) and nasopharyngeal lymphoma (NPL), and to explore the clinical value of quantitative parameters derived from dual-energy computed tomography (DECT) for distinguishing the two entities. Eighty patients including 51 with NPC and 29 with NPL were enrolled. The VMIs (+) at 40–80 keV with an interval of 10 keV were reconstructed by contrast enhanced images. The overall image quality and demarcation of lesion margins, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were assessed in VMIs (+) and polyenergetic images (PEI). Normalized iodine concentration (NIC), slope of the spectral Hounsfield unit curve (λHU) and effective atomic number (Zeff) were calculated. Diagnostic performance was assessed by receiver operating characteristic (ROC) curve. The 40 keV VMI (+) yielded highest overall image quality scores, demarcation of lesion margins scores, SNR and CNR. The values of NIC, λHU and Zeff in NPL were higher than those in NPC (P 
ISSN:0720-048X
1872-7727
DOI:10.1016/j.ejrad.2021.109532