Abstract
The accurate diagnosis of malignant cervical lymphadenopathy remains challenging. In this study, we determined the value of quantitative parameters derived from dual-energy computed tomography (DECT) for differentiating malignant cervical lymphadenopathy caused by thyroid carcinoma (TC), salivary gland carcinoma (SC), squamous cell carcinoma (SCC) and lymphoma. We retrospectively analysed 92 patients with pathologically confirmed cervical lymphadenopathy due to TC, SC, SCC and lymphoma. All patients received a DECT scan before therapy. Using GSI (gemstone spectral imaging) Volume Viewer software, we analysed the enhanced monochromatic data, and the quantitative parameters we acquired included the iodine concentration (IC), water concentration (WC) and the slope of the spectral HU curve (λHU). One-way ANOVA showed significant differences in the IC and λHU among different groups (P < 0.05). Post-hoc pairwise comparisons demonstrated the IC and λHU of TC group were significantly higher than those of SC, SCC and lymphoma groups (P < 0.05). In addition, the IC and λHU of SC group were significantly higher than those of the SCC and lymphoma groups (P < 0.05). Other comparisons of IC and λHU values showed no significant differences (P > 0.05). The quantitative parameters derived from DECT were useful supplements to conventional computed tomography images and were helpful for distinguishing different malignant cervical lymphadenopathies.
Highlights
The neck is rich in lymph nodes, with approximately 40% of the total lymph nodes in the human bod[1]
Dual-energy computed tomography (DECT) with the latest gemstone detector allows for reconstruction of virtual monochromatic images and material decomposition images[8,9,10,11,12] and provides multiple quantitative parameters that have been used for the diagnosis of lymph node metastasis for several types of tumours[12,13,14,15]
The qualitative diagnosis of malignant lesions in the cervical lymph node directly affects the selection of treatment options and the patient prognosis[16,17]
Summary
The neck is rich in lymph nodes, with approximately 40% of the total lymph nodes in the human bod[1]. Cervical lymph node lesions are variable, and the malignancy rate is over 50%1,2. Lymph node metastatic carcinoma and lymphoma are the most common cervical malignant lesions, with cervical lymph node metastatic carcinoma accounting for approximately 3/4 of all malignant neck tumours. It would be valuable to identify the nature and types of cervical lymph node lesions before selecting clinical treatments[5,6]. Imaging of cervical lymphadenopathy is a challenge owing to the difficulty of diagnosing malignant lymph nodes accurately before treatment. To our knowledge, the value of DECT for the preoperative diagnosis of cervical nodal metastasis in patients with different malignant carcinomas has not been well evaluated. The purpose of this study was to investigate the application of DECT to identify different malignancies in cervical lymph nodes
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
