Detectability of Head and Neck Cancer via New Computed Tomography Reconstruction Tools including Iterative Reconstruction and Metal Artifact Reduction.

Daniel Troeltzsch,Jan-Dirk Raguse,Seyd Shnayien,Kilian Kreutzer,Max Heiland,Stefan M Niehues,Bernd Hamm

doi:10.3390/diagnostics11112154

Daniel Troeltzsch, Jan-Dirk Raguse + Show 5 more

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https://doi.org/10.3390/diagnostics11112154

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Abstract

State-of-the-art technology in Computed Tomography (CT) includes iterative reconstruction algorithms (IR) and metal artefact reduction (MAR) techniques. The objective of the study is to show the benefits of this technology for the detection of primary and recurrent head and neck cancer. A total of 131 patients underwent contrast-enhanced CT for diagnosis of primary and recurrent Head and Neck cancer; 110 patients were included. All scans were reconstructed using iterative reconstruction, and metal artifact reduction was applied when indicated. Tumor detectability was evaluated dichotomously. Histopathological findings were used as a standard of reference. Data were analyzed retrospectively, statistics was performed through diagnostic test characteristics. State-of-the-art Head and Neck CT showed a sensitivity of 0.83 (95% CI; 0.61–0.95) with 0.93 specificity (95% CI; 0.84–0.98) for primary tumor detection. Recurrent tumors were identified with a 0.94 sensitivity (95% CI; 0.71–0.99) and 0.93 specificity (95% CI; 0.84–0.98) in this study. Conclusion: State-of-the-art reconstruction tools improve the diagnostic quality of Head and Neck CT, especially for recurrent tumor detection, compared with data published for standard CT. IR and MAR are easily implemented in routine clinical settings and improve image evaluation by reducing artifacts and image noise while lowering radiation exposure.

Highlights

According to the WHO World Cancer Report, cancer of the head and neck (H&N) is the seventh most frequently occurring cancer worldwide [1]
The median additional reconstruction time required for a Single-Energy Metal Artifact Reduction (SEMAR) dataset was 224 sec
Our study provides important information regarding the performance of Computed Tomography (CT) in the Our study provides important information regarding the performance of CT in the head and neck area

Summary

Introduction

According to the WHO World Cancer Report, cancer of the head and neck (H&N) is the seventh most frequently occurring cancer worldwide [1]. The GLOBOCAN database indicates that over 700,000 new cases of lip, oral, oropharyngeal, hypopharyngeal, and nasopharyngeal cancer, as well as cancer of the salivary glands combined are reported annually across the globe [2]. Oral squamous cell carcinoma is the most common oral malignancy, accounting for 80–90% of cases [3]. Patient outcomes can be improved by early detection and effective treatment before cancer spreads to lymph nodes or distant organs. Mortality depends on the tumor stage at diagnosis. With approximately 145 deaths per 100,000 inhabitants worldwide, mortality rates of HNSCC are high [4]

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