The value of dual-layer spectral detector CT in preoperative T staging of laryngeal and hypopharyngeal squamous cell carcinoma

Abstract

PurposeTo explore the optimal kiloelectron voltage (keV) of virtual monochromatic images (VMIs) of dual-layer spectral detector computed tomography (DLSCT) to display laryngeal and hypopharyngeal squamous cell carcinoma (LHSCC) and its diagnostic performance for preoperative T staging of LHSCC. MethodsA total of 67 LHSCC patients were included, and the contrast between the tumor and sternocleidomastoid muscle (SM), signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image noise of 40–100 keV VMIs and conventional polyenergetic images (CIs) were evaluated. The image quality of the CI and 40–100 keV VMI was evaluated by a five-point method. The VMI with the best image quality was screened out, and the accuracy of the optimal keV VMI and CI for T staging was assessed using clinical T staging as the reference standard. ResultsThe contrast between the tumor and SM, SNR, CNR and subjective image quality scores of LHSCC on 40–50 keV VMIs were higher than those on CIs (P < 0.05); the image noises of 40–100 keV VMIs were lower than those of CIs (P < 0.05). The 40 keV VMI had the highest SNR, CNR and subjective score of image quality. The accuracy rates of the 40 keV VMI and CI for T staging of LHSCC were 0.86 and 0.63 (P < 0.001), respectively. ConclusionThe image quality of 40–50 keV VMI is higher than that of CI, and the diagnostic accuracy of 40 keV VMI is better than that of CI, which is most suitable for preoperative T staging of LHSCC.