Journal of Cancer Research and Therapeutics

ORIGINAL ARTICLE
Year
: 2015  |  Volume : 11  |  Issue : 6  |  Page : 202--204

Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes


Fei Fu, Anwei He, Yue Zhang, Baojiu Li, Yeda Wan 
 Department of Radiology, Tianjin Hospital, Tianjin 300211, P.R, China

Correspondence Address:
Yeda Wan
Department of Radiology, Tianjin Hospital, No. 406, Jiefangnan Road, Hexi District, Tianjin 300211
China

Abstract

Objective: The aim of this study was to evaluate the clinical value of dua-energy virtual noncontrast imaging (DVNCT) in the diagnosis of cervical metastasis lymph nodes. Materials and Methods: From February 2014 to January 2015, 41 patients with 98 enlarged cervical lymph nodes were recruited in this study. All the enlarged lymph nodes were pathology confirmed. The patients received DVNCT and conventional noncontrast scan. The difference of average computed tomography (CT) value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and lesion detectability between virtual noncontrast imaging and conventional noncontrast scan were compared. The radiation dose of virtual noncontrast imaging and real noncontrast imaging of cervical lymph node were also compared. The diagnostic sensitivity and specificity for DVNCT was also evaluated. Results: No statistical difference of average CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and radiation dosage between virtual noncontrast imaging and conventional noncontrast scan were found. However, the radiation dosage of DVNCT was significant lower than that of conventional noncontrast scan (P < 0.05). The diagnostic sensitivity and specificity for malignant metastasis lymph node were 88.6% and 70.3% by DVNCT. Conclusion: DVNCT combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dosage.



How to cite this article:
Fu F, He A, Zhang Y, Li B, Wan Y. Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes.J Can Res Ther 2015;11:202-204


How to cite this URL:
Fu F, He A, Zhang Y, Li B, Wan Y. Dua-energy virtual noncontrast imaging in diagnosis of cervical metastasis lymph nodes. J Can Res Ther [serial online] 2015 [cited 2022 Sep 26 ];11:202-204
Available from: https://www.cancerjournal.net/text.asp?2015/11/6/202/168185


Full Text

 Introduction



Cervical lymph node enlargement is common and frequently occurring for many diseases including malignant disease and infection.[1] The different nature of the lymph node disease determines the treatment plan and the prognosis of the patients. Moreover, the accurate pretreatment diagnosis for enlarged lymph node is essential for treatment procedure.[2] At present, the ultrasound, computed tomography, and magnetic resonance imaging are major methods for detection and diagnosis of enlarged cervical lymph nodes.[3],[4] The accurate assess of the site of cervical lymph nodes enlargement, size, shape, internal structure, and relationship with adjacent organs needs conventional noncontrast scan and enhancement computed tomography (CT) scan. However, the X-ray exposure for patients cannot be ignored especially for patients who repeated receiving CT scan. Recently, some reports indicated that the dua-energy virtual noncontrast imaging (DVNCT) is efficacy in the evaluation of cervical enlarged lymph nodes.[5] Thus, we performed this study to further assess the clinical efficacy of DVNCT in assessing the malignant metastasis lymph nodes.

 Materials and Methods



From February 2014 to January 2015, 41 patients with 98 enlarged cervical lymph nodes were recruited in this study. The mean age of the patients was 48.6 ± 18.8. For the included 41 patients, 26 were male and 15 were female. Ninety-eight enlarged lymph nodes from the 41 cases were pathology confirmed [Table 1]. The patients received DVNCT and conventional noncontrast scan. The difference of average CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and lesion detectability between virtual noncontrast imaging and conventional noncontrast scan were compared. The radiation dose of virtual noncontrast imaging and real noncontrast imaging of cervical lymph node were also compared. The diagnostic sensitivity and specificity for DVNCT was also evaluated.{Table 1}

Statistical analysis

Data are expressed as the mean ± standard deviation. The Student's t-test was used for analyzing the difference between DVNCT and CNCS. The diagnosis sensitivity and specificity were calculated according to Bayes theorem. Statistical analysis was performed using SPSS version 18.0 software (SPSS Inc., USA, http://www-10.ibm.com/software/analytics/spss). Statistical significance was accepted at P < 0.05.

 Results



Computed tomography value, signal noise ratio, contrast to noise ratio, and image quality score comparison

The CT value of DVNCT were 51.3 ± 22.0 and 55.8 ± 24.1 Hu for the arterial phase and venous phase which showed no statistical difference to conventional noncontrast scan 50.4 ± 11.6 (P > 0.05). The signal noise ratio, contrast to noise ratio, and image quality score were also not statistical different between DVNCT and conventional noncontrast scan [Table 2] and [Figure 1].{Table 2}{Figure 1}

Radiation dosage comparison

We also compared the radiation dosage for DVNCT and conventional noncontrast scan. The CT dose index volume (CTDIvol), dose length product (DLP), and effective dose (ED) were 62.3 ± 8.1 mGy, 1921.6 ± 289.8 mGy·cm, and 10.88 ± 2.1 mSv for the DVNCT. The CTDIvol, DLP, and ED were 88.6 ± 7.9 mGy, 2441.3 ± 223.6 mGy·cm, and 14.6 ± 1.9 mSv for the conventional noncontrast scan. The CTDIvol, DLP, and ED were significant lower in DVNCT compared to CNCS with statistical difference (P < 0.05) [Table 3].{Table 3}

Diagnostic value malignant metastatic lymph nodes

The diagnostic sensitivity and specificity were 88.6% and 70.3% for malignant metastasis enlarged lymph nodes by DVNCT.

 Discussion



The occurrence of cervical lymph node metastasis is common in malignant head and neck carcinoma patients and other cancers such as lung cancer and esophageal cancer.[6] The presence of metastasis cervical lymph nodes can affect the treatment procedure and prognosis of the primary disease.[7] Thus, the detection of cervical lymph nodes nature is very important for a treatment plan.[8] At present, the ultrasound, CT, and magnetic resonance imaging are major methods for detection and diagnosis of enlarged cervical lymph nodes. The accurate assess of the site of cervical lymph nodes enlargement, size, shape, internal structure, and relationship with adjacent organs needs conventional noncontrast scan and enhancement CT scan.[9] However, the radiation dosage of the conventional noncontrast scan and enhancement CT scan were relative high. A recent study showed that the DVNCT can provide well imaging quality and low radiation exposure for patients with enlarged cervical lymph nodes.[10]

In our study, we evaluate the diagnostic specificity, sensitivity average CT value, signal to noise ratio, a contrast to noise ratio, image subjective assessment, and radiation dosage of DVNCT in asses of cervical metastasis lymph nodes. We found that the average CT value, signal to noise ratio, a contrast to noise ratio, and image quality were not inferior in DVNCT compared to conventional noncontrast scan. However, the radiation dosage in DVNCT was much lower than that of the conventional noncontrast scan. Moreover, the diagnostic sensitivity and specificity were relative high for detection of malignant metastasis lymph nodes. Hence, the DVNCT combined with contrast imaging can provide clear images in the diagnosis of enlarged cervical lymph nodes and reduce radiation dosage.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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