@article{JTD34158,
author = {Lin Li and Sai-Nan Cheng and Yan-Feng Zhao and Xiao-Yi Wang and De-Hong Luo and Yong Wang},
title = {Diagnostic accuracy of single-source dual-energy computed tomography and ultrasonography for detection of lateral cervical lymph node metastases of papillary thyroid carcinoma},
journal = {Journal of Thoracic Disease},
volume = {11},
number = {12},
year = {2019},
keywords = {},
abstract = {Background: Dual-energy computed tomography (DECT) imaging can generate iodine-based material decomposition (MD) images and spectral HU curve. This study aimed to investigate the diagnostic accuracy of single-source dual-energy CT (DECT) and ultrasonography (US) for detecting lateral cervical lymph node metastases of papillary thyroid carcinoma (PTC).
Methods: Thirty patients with PTC were enrolled in the study and underwent DECT and US examination before thyroidectomy and cervical lymph node dissection. The spectral parameters included iodine concentration (IC), normalized iodine concentration (NIC) and slope (λHU) of lymph nodes. The CT morphological parameters included maximal short diameter, shape, margin, calcification and cystic degeneration of lymph nodes. The US morphological parameters included maximal short diameter, calcification and cystic degeneration of lymph nodes. The diagnostic value of every single spectral parameter, combined gemstone spectral image (GSI) parameters, CT morphological parameters and US morphological parameters between metastatic and non-metastatic lymph nodes were statistically compared. Receiver operating characteristic (ROC) curves, sensitivity, and specificity were used to determine the diagnostic value.
Results: Ninety-nine lymph nodes from thirty patients were pathologically confirmed. Among them, 70 (70.7%) were metastatic. For single GSI parameters, ROC analysis showed that the area under the curve (AUC) for IC was the highest (AUC =0.937) but the difference was not statistically significant when compared with NIC or slope (λHU) (P>0.05). The optimal diagnostic threshold for IC was 2.56 mg/mL, with a sensitivity, specificity and accuracy of 87.1%, 93.1%, and 88.9%, respectively. The AUC for combined GSI parameter (AUC =0.942) was higher compared with the US morphological parameters (AUC =0.771, P0.05).
Conclusions: Combined GSI parameters showed better diagnostic accuracy in lateral cervical lymph node metastasis of PTC compared with that of combined US morphological parameters. IC alone showed excellent diagnostic stability and could be performed easily.},
issn = {2077-6624}, url = {https://jtd.amegroups.org/article/view/34158}
}