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Dual-energy computed tomography for evaluating nodal staging in lung adenocarcinoma: correlation with surgical pathology

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Japanese Journal of Radiology Aims and scope Submit manuscript

Abstract

Purpose

To ascertain the performance of dual-energy CT (DECT) with iodine quantification in differentiating malignant mediastinal and hilar lymph nodes (LNs) from benign ones, focusing on patients with lung adenocarcinoma.

Materials and methods

In this study, patients with suspected lung cancer received a preoperative contrast-enhanced DECT scan from Jun 2018 to Dec 2020. Quantitative DECT parameters and the size were compared between metastatic and benign LNs. Their diagnostic performances were analyzed by the ROC curves and compared by using the two-sample t test.

Results

72 patients (23 men, 49 women; mean age 62.5 ± 10.1 years) fulfilled the inclusion criteria. A total of 98 LNs (67 benign, 31 metastatic) were analyzed. The iodine concentration normalized by muscle (NICmuscle) was significantly higher (P < 0.001) in metastatic LNs (4.79 ± 1.70) than in benign ones (3.00 ± 1.45). The optimal threshold of NICmuscle was 3.44, which yielded AUC: 0.798, sensitivity: 83.9%, specificity: 73.1%, accuracy: 76.5%, respectively. Applying the established size parameters with 10 mm as the threshold yielded AUC: 0.600, sensitivity: 29.0%, specificity: 91.0%, accuracy: 71.4%, respectively. The diagnostic performance of NICmuscle was significantly better (P = 0.007) than the performance obtained using the established size parameters.

Conclusions

For lung adenocarcinoma, the quantitative measurement of NICmuscle derived from DECT is useful for differentiating benign and metastatic mediastinal and hilar LNs before surgical intervention.

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Data Availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

This study has received funding by Ministry of Science and Technology, Taiwan, R.O.C. 109-2221-E-002 -035 -MY3.

Funding

This study has received funding by Ministry of Science and Technology (MOST). 109-2221-E-002-035-MY3.

Author information

Authors and Affiliations

  1. Department of Medical Imaging, Taipei City Hospital, Yangming Branch, No. 105, Yusheng St., Shilin Dist., Taipei City, 111024, Taiwan

    Hsu-Cheng Huang & Teh-Chen Wang

  2. Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan

    Hsu-Cheng Huang, Yu-Sen Huang, Yu-Chien Chang & Yeun-Chung Chang

  3. Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan

    Jin-Yuan Shih

  4. Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, No.7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City, 100225, Taiwan

    Jin-Shing Chen

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  1. Hsu-Cheng Huang
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Contributions

Conceptualization: HCH, YSH, YCC, JYS, JSC, YCC, TCW. Data curation: HCH, YSH, YCC. Formal analysis: HCH, YSH, YCC. Funding acquisition: YCC, TCW. Investigation: HCH, YSH, YCC, JYS, JSC. Methodology: HCH, YSH, YCC, JYS, JSC. Project administration: HCH, YSH, YCC. Resources: JYS, JSC, YCC, TCW. Software: HCH, YSH, YCC, YCC, TCW. Supervision: YCC, TCW. Validation: YSH, YCC, JYS, JSC, YCC, TCW. Writing-original draft: HCH. Writing-review and editing: YSH, YCC, YCC, TCW. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Teh-Chen Wang.

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Conflict of interest

The authors declare that they have no competing interests. The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

Our clinical study received institutional review board approval and was compliant with HIPAA requirements. The study was performed per the ethical standards as laid down in the 1964 Declaration of Helsinki.

Consent to participate

Written informed consent was obtained from all the study participants.

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Manuscript does not contain data from any individual person.

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Cite this article

Huang, HC., Huang, YS., Chang, YC. et al. Dual-energy computed tomography for evaluating nodal staging in lung adenocarcinoma: correlation with surgical pathology. Jpn J Radiol 42, 468–475 (2024). https://doi.org/10.1007/s11604-023-01525-9

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  • DOI: https://doi.org/10.1007/s11604-023-01525-9

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