A Single Enhanced Dual-Energy CT Scan May Distinguish Lung Squamous Cell Carcinoma From Adenocarcinoma During the Venous phase

To investigate whether iodine quantification extracted from enhanced dual energy-computed tomography (DE-CT) is useful for distinguishing lung squamous cell carcinoma from adenocarcinoma and to evaluate whether a single scan evaluated during the venous phase (VP) can be substituted for scans evaluat...

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Bibliographic Details
Published in:	Academic radiology Vol. 27; no. 5; pp. 624 - 629
Main Authors:	Zhang, Zhaotao, Zou, Hongye, Yuan, Aimei, Jiang, Fei, Zhao, Baolin, Liu, Yin, Chen, Jinghua, Zuo, Minjing, Gong, Lianggeng
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-05-2020
Subjects:	Adenocarcinoma Dual-energy CT Iodine quantification Lung squamous carcinoma Adenocarcinoma DSCT DE-CT Iodine quantification ROC NIC AP AUC Lung squamous carcinoma Dual-energy CT VP IC MVD
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Summary:	To investigate whether iodine quantification extracted from enhanced dual energy-computed tomography (DE-CT) is useful for distinguishing lung squamous cell carcinoma from adenocarcinoma and to evaluate whether a single scan evaluated during the venous phase (VP) can be substituted for scans evaluated during other phases. Sixty-two patients with lung cancer (32 squamous cell carcinomas; 30 adenocarcinomas) underwent enhanced dual-phase DE-CT scans, including an arterial phase and VP. The iodine concentration (IC), normalized iodine concentration (NIC), and slope of the curve (K) in lesions were measured during two scanning phases in two different pathological types of lung cancers. The differences in parameters (IC, NIC, and K) between these two types of lung cancers were statistically analyzed. In addition, the receiver operating characteristic curves of these parameters were performed to discriminate squamous cell carcinoma from adenocarcinoma. The mean IC, NIC, and K in adenocarcinomas were all higher than those in squamous cell carcinomas during the two scanning phases. However, the differences in these parameters between the two types of cancers were significant only during the VP, not during the arterial phase. Receiver operating characteristic analysis demonstrated that the optimal thresholds of the IC, NIC, and K for discriminating squamous cell carcinoma from adenocarcinoma were 1.550, 0.227, and 1.608, respectively. In addition, the sensitivity, specificity, and area under the curve were 81.2%, 83.3%, and 0.871 for the IC; 56.2%, 93.3%, and 0.800 for the NIC; and 65.6%, 80%, and 0.720 for the K; 81.3%, 83.3%, and 0.874 for the IC + NIC; 68.8%, 93.3%, and 0.891 for the IC + NIC + K, respectively. The “IC + NIC + K” had the highest diagnostic efficiency for discriminating two types of lung cancers, but with low sensitivity. Whereas, “IC”and “IC + NIC” had the similar lower diagnostic efficiency, but with high sensitivity and specificity. The iodine quantification parameters derived from enhanced DE-CT during the VP may be useful for distinguishing lung squamous cell carcinoma from adenocarcinoma.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1076-6332 1878-4046
DOI:	10.1016/j.acra.2019.07.018