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Congress: ECR25
Poster Number: C-20846
Type: Poster: EPOS Radiologist (scientific)
DOI: 10.26044/ecr2025/C-20846
Authorblock: R. Gahrmann, M. L. Dijkshoorn; Rotterdam/NL
Disclosures:
Renske Gahrmann: Nothing to disclose
Marcel L. Dijkshoorn: Nothing to disclose
Keywords: Head and neck, CT, Staging, Cancer, Tissue characterisation
Purpose Detecting cervical lymph node (LN) metastases in primary head-neck squamous cell carcinoma (HNSCC) can be challenging, often requiring fine-needle aspiration (FNA) in suspicious LNs after initial (PET)-CT or MRI imaging. Not only is this an extra burden for the patient, but it also increases costs and delays the start of treatment for these fast-growing tumors. This pilot study aims to evaluate whether Dual-Energy CT (DECT)-derived parameters can differentiate between normal and pathological LNs in HNSCC, potentially eliminating the need for...
Read more Methods and materials DECT allows for the creation of virtual monochromatic images (VMIs) between 40 and 140 keV. By plotting HU values from a region-of-interest (ROI) in a spectral attenuation curve, one can calculate the slope (k) between selected energy levels. Additionally, DECT facilitates the calculation of virtual non-contrast (VNC) images and iodine concentration (IC), and utilized material decomposition to estimate effective anatomic number (Zeff) and electon density (ρe)(1).The uptake of iodine within a tumor reflects tumor hemodynamics and perfusion (specific to the...
Read more Results Between November 2014 and March 2016, a total of 178 DECT scans of the neck were performed, 66 of which in patients with primary HNSCC. Other pathologies included thyroid cancer and lymphoma (n=35), infection (n=22), post-treatment HNSCC (n=24) and benign lesions (n=32).Out of the 66 patients with HNSCC, 38 had either a hypopharyngeal (n=6) or laryngeal (n=32) tumor. Four patients were excluded from the analysis due to the absence of pathologically confirmed malignancy (n=1), primary tumor size <0.1 cm3 (n=2),...
Read more Conclusion None of the measured DECT-derived parameters were significantly different between normal and metastatic lymph nodes (LN). This finding suggests that the semi-quantitative measures obtained through DECT, do not provide sufficient distinction between normal and metastatic LNs. Consequently, these measures are inadequate for reliably identifying or characterizing suspicious LNs in clinical practice. Further studies may be necessary to explore alternative imaging techniques or additional biomarkers that could enhance the differentiation between normal and metastatic LNs, potentially improving diagnostic accuracy and patient...
Read more References Schaeffer CJ, Leon SM, Olguin CA, Arreola MM. Accuracy and reproducibility of effective atomic number and electron density measurements from sequential dual energy CT. Med Phys. juli 2021;48(7):3525-39. Santos Armentia E, Martín Noguerol T, Silva Priegue N, Delgado Sánchez-Gracián C, Trinidad López C, Prada González R. Strengths, weaknesses, opportunities, and threat analysis of dual-energy CT in head and neck imaging. Radiol Engl Ed. juli 2022;64(4):333-47. Shen H, Huang Y, Yuan X, Liu D, Tu C, Wang Y, e.a. Using quantitative parameters derived...
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