Dual-source dual-energy thin-section CT combined with small field of view technique for small lymph node in thyroid cancer: a retrospective diagnostic study

作者：Shuiqing Zhuo, Jiayuan Sun, Jinyong Chang, Longzhong Liu, Sheng Li · 发表于：Gland Surgery · 年份：2021 · DOI：10.21037/gs-20-822 · 被引用次数：11 · 研究领域：Advanced X-ray and CT Imaging、Thyroid Cancer Diagnosis and Treatment、Dental Radiography and Imaging

BACKGROUND: To evaluate the diagnostic performance of quantitative spectral parameters derived from dual-source dual-energy CT at small field of view (FOV) for small lymph node metastasis in thyroid cancer. METHODS: This was a retrospective diagnostic study. From 2016 to 2019, 280 patients with thyroid disease underwent thin-section dual-source dual-energy thyroid CT and thyroid surgery. The data of patients with lymph nodes having a short diameter of 2-6 mm was analyzed. The quantitative dual-energy CT parameters of targeted lymph nodes were measured, and all parameters between metastatic and non-metastatic lymph nodes were compared. These parameters were then fitted to univariable and multivariable binary logistic regression models. The diagnostic role of spectral parameters was analyzed by receiver operating characteristic (ROC) curves and compared with the McNemar test. Small FOV CT images and a mathematical model were used to judge the status of lymph nodes respectively, and then compared with the golden criterion-pathological diagnosis. The cut-off value of the model was 0.4419, with a sensitivity of 90.2% and a specificity of 92.7%. RESULTS: Of the 216 lymph nodes investigated in this study, 52.3% and 23.6% had a short diameter of 2-3 and 4 mm, respectively. Multiple quantitative CT parameters were significantly different between benign and malignant lymph nodes, and binary regression analysis was performed. The mathematical model was: p=ey/(1+ ey), y=-23.119+0.033× pr...