Multiparametric Evaluation of Head and Neck Squamous Cell Carcinoma Using a Single-Source Dual-Energy CT with Fast kVp Switching: State of the Art.

Stephanie Lam,Rajiv Gupta,Reza Forghani,Hugh Curtin,Hillary Kelly

doi:10.3390/cancers7040886

Abstract

There is an increasing body of evidence establishing the advantages of dual-energy CT (DECT) for evaluation of head and neck squamous cell carcinoma (HNSCC). Focusing on a single-source DECT system with fast kVp switching, we will review the principles behind DECT and associated post-processing steps that make this technology especially suitable for HNSCC evaluation and staging. The article will review current applications of DECT for evaluation of HNSCC including use of different reconstructions to improve tumor conspicuity, tumor-normal soft tissue interface, accuracy of invasion of critical structures such as thyroid cartilage, and reduce dental artifact. We will provide a practical approach for DECT implementation into routine clinical use and a multi-parametric approach for scan interpretation based on the experience at our institution. The article will conclude with a brief overview of potential future applications of the technique.

Highlights

There has been interest in dual-energy computed tomography (DECT) since the 1970s, it is not until recent technological advances permitting almost simultaneous image acquisition at two different energy levels in a single scan that DECT has become possible for routine clinical use
The findings suggest that high energy virtual monochromatic image (VMI) may be helpful for evaluating thyroid cartilage invasion
It is likely that additional refinements in technique and recommendations for use of different reconstructions for head and neck squamous cell carcinoma (HNSCC) evaluation will emerge for the different DECT platforms in the near future

Summary

Introduction

There has been interest in dual-energy computed tomography (DECT) since the 1970s, it is not until recent technological advances permitting almost simultaneous image acquisition at two different energy levels in a single scan that DECT has become possible for routine clinical use. There is increasing evidence supporting the advantages of using DECT for evaluating head and neck pathology, with specific applications for head and neck squamous cell carcinoma (HNSCC) [8,9,10,11,12,13,14,15,16,17]. We will provide a brief overview of advanced DECT analysis and other potential future applications for head and neck cancer evaluation

Basic Principles of DECT

Types of DECT Scanners

Other Potential DECT Applications for the Evaluation of HNSCC

Findings

10. Future Prospects and Concluding Remarks