Abstract
PurposeThe purpose of this study was to evaluate image quality and status of lymph nodes in laryngeal and hypopharyngeal squamous cell carcinoma (SCC) patients using spectral CT imaging.Materials and MethodsThirty-eight patients with laryngeal and hypopharyngeal SCCs were scanned with spectral CT mode in venous phase. The conventional 140-kVp polychromatic images and one hundred and one sets of monochromatic images were generated ranging from 40 keV to 140 keV. The mean optimal keV was calculated on the monochromatic images. The image quality of the mean optimal keV monochromatic images and polychromatic images was compared with two different methods including a quantitative analysis method and a qualitative analysis method. The HU curve slope (λHU) in the target lymph nodes and the primary lesion was calculated respectively. The ratio of λHU was studied between metastatic and non-metastatic lymph nodes group.ResultsA total of 38 primary lesions were included. The mean optimal keV was obtained at 55±1.77 keV on the monochromatic images. The image quality evaluated by two different methods including a quantitative analysis method and a qualitative analysis method was obviously increased on monochromatic images than polychromatic images (p<0.05). The ratio of λHU between metastatic and non-metastatic lymph nodes was significantly different in the venous phase images (p<0.05).ConclusionThe monochromatic images obtained with spectral CT can be used to improve the image quality of laryngeal and hypopharyngeal SCC and the N-staging accuracy. The quantitative ratio of λHU may be helpful for differentiating between metastatic and non-metastatic cervical lymph nodes.
Highlights
Laryngeal and hypopharyngeal squamous cell carcinoma (SCC) are one of the most common malignant tumors in head and neck tumor
The mean optimal keV was obtained at 5561.77 keV on the monochromatic images
The image quality evaluated by two different methods including a quantitative analysis method and a qualitative analysis method was obviously increased on monochromatic images than polychromatic images (p,0.05)
Summary
Laryngeal and hypopharyngeal SCC are one of the most common malignant tumors in head and neck tumor. The extent of the tumor and the detection of metastatic lymph nodes have essential impact on treatment decision for laryngeal and hypopharyngeal SCC, and tumor volume measured by pretreatment CT is increasingly considered to have the highest prognostic impact regarding local recurrence[1,2,3,4,5,6,7]. Tumor volume would be able to accurately measure depends on the better image quality. The extension and volume of laryngeal and hypopharyngeal SCC can not accurately be assessed by conventional CT imaging examination [8]. Two most frequently used imaging methods, contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) allow detection of enlarged nodes with necrosis and external diffusion [9], but neither method can accurately differentiate nonmetastatic from metastatic, non-enlarged lymph nodes [10]
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