Skip to main content

Advertisement

SpringerLink
Log in

Differentiating malignant vertebral tumours from non-malignancies with CT spectral imaging: a preliminary study

  • Computed Tomography
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To investigate the value of dual-energy spectral computed tomography (DESCT) for differentiating malignant vertebral tumours from non-malignancies during venous phase.

Methods

This study was institutional review board-approved, and written informed consent was obtained from all patients. Thirty-seven patients were examined by DESCT during venous phase. Twenty patients had malignant vertebral tumours, 17 had non-malignant vertebral tumours. The iodine/water densities for the lesion, the lesion-to-muscle ratio, and lesion-to-artery ratio for iodine density measurements were calculated and compared between the two groups with the two-tailed Student t test. A p-value < 0.05 was considered statistically significant. Sensitivity and specificity were compared between the qualitative and quantitative studies.

Results

The iodine density, lesion-to-muscle ratio, and lesion-to-artery ratio of the iodine density measurement for malignant vertebral tumours were significantly different from the respective values for non-malignancies (all p < 0.05). Using 0.52 as the threshold value for the lesion-to-artery iodine density ratio, one could obtain sensitivity of 85 % and specificity of 100 % for differentiating malignant vertebral tumours from non-malignancies, significantly higher than the qualitative diagnosis.

Conclusions

DESCT imaging enables analysis of a number of additional quantitative CT parameters to improve the accuracy for differentiating malignant vertebral tumours from non-malignancies during venous phase.

Key Points

• Dual-energy CT provides a new quantitative method.

• CT spectral imaging improves the accuracy of differential diagnosis.

• Lesion-to-artery iodine density ratio for malignant vertebral tumours was higher than for non-malignancies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

DESCT:

Dual-energy spectral computed tomography

MVT:

Malignant vertebral tumour

NMVT:

Non-malignant vertebral tumour

LMR:

Lesion-to-muscle ratio

LAR:

Lesion-to-artery ratio

GSI:

Gemstone spectral imaging

ROI:

Regions of interest

ROC:

Receiver operating characteristic curve

References

  1. Van Goethem JW, van den Hauwe L, Ozsarlak O, De Schepper AM, Parizel PM (2004) Spinal tumors. Eur J Radiol 50:159–176

    Article  PubMed  Google Scholar 

  2. Bilsky MH, Shannon FJ, Sheppard S, Prabhu V, Boland PJ (2002) Diagnosis and management of a metastatic tumor in the atlantoaxial spine. Spine (Phila Pa 1976) 27:1062–1069

    Article  Google Scholar 

  3. Clarke MJ, Mendel E, Vrionis FD (2014) Primary spine tumors: diagnosis and treatment. Cancer Control 21:114–123

    PubMed  Google Scholar 

  4. Hsu W, Kosztowski TA, Zaidi HA, Dorsi M, Gokaslan ZL, Wolinsky JP (2009) Multidisciplinary management of primary tumors of the vertebral column. Curr Treat Options Oncol 10:107–125

    Article  PubMed  Google Scholar 

  5. Erlemann R (2006) Imaging and differential diagnosis of primary bone tumors and tumor-like lesions of the spine. Eur J Radiol 58:48–67

    Article  CAS  PubMed  Google Scholar 

  6. Rodallec MH, Feydy A, Larousserie F, Anract P, Campagna R, Babinet A, Zins M, Drape JL (2008) Diagnostic imaging of solitary tumors of the spine: what to do and say. Radiographics 28:1019–1041

    Article  PubMed  Google Scholar 

  7. Murphey MD, Andrews CL, Flemming DJ, Temple HT, Smith WS, Smirniotopoulos JG (1996) From the archives of the AFIP Primary tumors of the spine: radiologic pathologic correlation. Radiographics 16:1131–1158

    Article  CAS  PubMed  Google Scholar 

  8. Simons D, Kachelriess M, Schlemmer HP (2014) Recent developments of dual-energy CT in oncology. Eur Radiol 24:930–939

    Article  PubMed  Google Scholar 

  9. Lv P, Lin XZ, Li J, Li W, Chen K (2011) Differentiation of small hepatic hemangioma from small hepatocellular carcinoma: recently introduced spectral CT method. Radiology 259:720–729

    Article  PubMed  Google Scholar 

  10. Silva AC, Morse BG, Hara AK, Paden RG, Hongo N, Pavlicek W (2011) Dual-energy (spectral) CT: applications in abdominal imaging. Radiographics Rev Publ Radiol Soc N Am Inc 31:1031–1046, discussion 1047-1050

    Google Scholar 

  11. Marin D, Boll DT, Mileto A, Nelson RC (2014) State of the art: dual-energy CT of the abdomen. Radiology 271:327–342

    Article  PubMed  Google Scholar 

  12. Pessis E, Campagna R, Sverzut JM, Bach F, Rodallec M, Guerini H, Feydy A, Drape JL (2013) Virtual monochromatic spectral imaging with fast kilovoltage switching: reduction of metal artifacts at CT. Radiographics 33:573–583

    Article  PubMed  Google Scholar 

  13. Lin XZ, Wu ZY, Tao R, Guo Y, Li JY, Zhang J, Chen KM (2012) Dual energy spectral CT imaging of insulinoma-Value in preoperative diagnosis compared with conventional multi-detector CT. Eur J Radiol 81:2487–2494

    Article  PubMed  Google Scholar 

  14. Tang L, Zhang XP, Sun YS, Li YL, Li XT, Cui Y, Gao SY (2013) Spectral CT in the demonstration of the gastrocolic ligament: a comparison study. Surg Radiol Anat 35:539–545

    Article  PubMed  Google Scholar 

  15. Patel BN, Kumbla RA, Berland LL, Fineberg NS, Morgan DE (2013) Material density hepatic steatosis quantification on intravenous contrast -enhanced rapid kilovolt (peak)-switching single-source dual-energy computed tomography. J Comput Assist Tomogr 37:904–910

    Article  PubMed  Google Scholar 

  16. Agrawal MD, Pinho DF, Kulkarni NM, Fineberg NS, Morgan DE (2014) Oncologic applications of dual-energy CT in the abdomen. Radiographics 34:589–612

    Article  PubMed  Google Scholar 

  17. Ko JP, Brandman S, Stember J, Naidich DP (2012) Dual-energy computed tomography: concepts, performance, and thoracic applications. J Thorac Imaging 27:7–22

    Article  PubMed  Google Scholar 

  18. Jiang T, Zhu AX, Sahani DV (2013) Established and novel imaging biomarkers for assessing response to therapy in hepatocellular carcinoma. J Hepatol 58:169–177

    Article  CAS  PubMed  Google Scholar 

  19. Apfaltrer P, Meyer M, Meier C, Henzler T, Barraza JM Jr, Dinter DJ, Hohenberger P, Schoepf UJ, Schoenberg SO, Fink C (2012) Contrast-enhanceddual-energy CT of gastrointestinal stromal tumors: is iodine-related attenuation a potential indicator of tumor response? Invest Radiol 47:65–70

    Article  CAS  PubMed  Google Scholar 

  20. Buhmann Kirchhoff S, Becker C, Duerr HR, Reiser M, Baur-Melnyk A (2009) Detection of osseous metastases of the spine: comparison of high resolution multi-detector-CT with MRI. Eur J Radiol 69:567–573

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The scientific guarantor of this publication is Huishu Yuan. The authors of this manuscript declare relationships with the following companies: GE Healthcare. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, diagnostic, or prognostic study/experimental, performed at one institution.

Author information

Authors and Affiliations

  1. Peking University Third Hospital, No.49 North Garden Street, Haidian District, Beijing, 100191, China

    Yuan Yuan, Yan Zhang, Ning Lang & Huishu Yuan

  2. CT imaging Research Center, GE Healthcare, Beijing, China

    Jianying Li

Authors
  1. Yuan Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ning Lang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jianying Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Huishu Yuan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Huishu Yuan.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yuan, Y., Zhang, Y., Lang, N. et al. Differentiating malignant vertebral tumours from non-malignancies with CT spectral imaging: a preliminary study. Eur Radiol 25, 2945–2950 (2015). https://doi.org/10.1007/s00330-015-3726-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-015-3726-z

Keywords

Search

Navigation