Dataset Information

Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients.

ABSTRACT:

Background

Accurate diagnosis of mediastinal lymph node (LN) metastases is very important for the treatment and prognosis in lung cancer patients. Spectral computed tomography (CT), as a non-invasive approach, has good prospects for detecting mediastinal nodal metastasis. However, the diagnostic criteria of differentiating metastatic and nonmetastatic LNs have not been determined.

Methods

Clinical and imaging data of 64 lung cancer patients (mean age 61.3±10.3 years, 41 men) from April to December 2019 were retrospectively analyzed. The unenhanced scan and contrast enhanced arterial phase (AP) and venous phase (VP) spectral CT scans were performed. The 70 keV monochromatic image and iodine-based image in all phases were analyzed to measure the parameters of LNs. LNs were divided into the metastatic and non-metastatic groups based on confirmative pathological results, and their differences were statistically analyzed. The receiver operating characteristics curve (ROC) was used to evaluate the efficacy of the differential diagnosis.

Results

Seventy-four metastatic LNs and 152 non-metastatic LNs were obtained. Compared with non-metastatic LNs, metastatic LNs often had a larger size (P<0.001). In the unenhanced scans, the density of metastatic LNs was lower than that of non-metastatic LNs (P<0.001); however, there was no difference in CT value in AP and VP between metastatic and non-metastatic LNs (P=0.07, P=0.08, respectively). A statistically significant difference was found in iodine concentration (IC), normalized iodine concentration (NIC) and slope of the spectral curve (λHU) in unenhanced scan, IC and λHU in AP, as well as IC, NIC and λHU in VP between metastatic and non-metastatic LNs. There was no difference in NIC in AP between them.

Conclusions

Combined with morphology, spectral CT quantitative parameters demonstrate certain diagnostic efficiency for differential diagnosis between metastatic and non-metastatic LNs in lung cancer patients.

SUBMITTER: Huang S

PROVIDER: S-EPMC8411177 | biostudies-literature | 2021 Aug

REPOSITORIES: biostudies-literature

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Publications

Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients.

Huang Suidan S Meng Hongjia H Cen Renli R Ni Zhiwen Z Li Xiaoling X Suwal Sushant S Chen Huai H

Journal of thoracic disease 20210801 8

<h4>Background</h4>Accurate diagnosis of mediastinal lymph node (LN) metastases is very important for the treatment and prognosis in lung cancer patients. Spectral computed tomography (CT), as a non-invasive approach, has good prospects for detecting mediastinal nodal metastasis. However, the diagnostic criteria of differentiating metastatic and nonmetastatic LNs have not been determined.<h4>Methods</h4>Clinical and imaging data of 64 lung cancer patients (mean age 61.3±10.3 years, 41 men) from ...[more]

PMID: 34527311

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Project description:ObjectiveEndobronchial ultrasound-guided transbronchial needle aspiration is of diagnostic value in hilar/mediastinal (N1/N2) lymph node staging. We assessed the utility of endobronchial ultrasound-guided transbronchial needle aspiration in lung cancer patients with N1/N2 lymph nodes detected on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.MethodsFifty lung cancer patients with N1/N2 disease on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography underwent endobronchial ultrasound-guided transbronchial needle aspiration for pathological lymph nodes between November 2012 and April 2015. The diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration, lymph node site and size, number of needle passes and complications were evaluated retrospectively from patients' medical records. Malignancy was defined as a maximum standardized uptake value (SUVmax) >2.5.ResultsThe median longest diameter of the 61 lymph nodes (29 subcarinal, 21 right lower paratracheal, 6 left lower paratracheal, 4 right hilar and 1 upper paratracheal) was 23.4 mm (range: 10.4-45.7); the median number of needle passes was 2 (range: 1-5). There were no severe complications. A definitive diagnosis was made by endobronchial ultrasound-guided transbronchial needle aspiration in 39 patients (31 adenocarcinomas, 3 small-cell carcinomas, 2 squamous-cell carcinomas, 3 large-cell neuroendocrine carcinomas). In the remaining 11 patients, the diagnosis was indefinite: insufficient endobronchial ultrasound-guided transbronchial needle aspiration material was collected in two patients and non-specific lymphadenopathy was confirmed by endobronchial ultrasound-guided transbronchial needle aspiration or thoracotomy in the other nine patients. The mean lymph node SUVmax was 7.09 (range: 2.90-26.9) and was significantly higher in true-positive than in false-positive nodes (P < 0.05, t-test). Non-specific lymphadenopathy was diagnosed by expert visual interpretation of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography images in five of the nine patients.ConclusionEndobronchial ultrasound-guided transbronchial needle aspiration accurately diagnoses N1/N2 disease detected on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography.

Project description:BackgroundBreast cancer (BC) is a common cancer among women worldwide, and although the use of neoadjuvant therapy (NAT) for BC has become more widespread, there is no standardized prediction of the efficacy of NAT for BC. This study aimed to evaluate the value of quantitative parameters of dual-layer detector spectral computed tomography (DLCT) in predicting whether BC patients can achieve pathological complete response (pCR) after NAT.MethodsPatients who were first diagnosed with BC in Shandong Cancer Hospital and Institute and received only NAT before surgery were selected for participation in this study. All breast computed tomography (CT) imaging examinations were performed using DLCT, within 1 week before initiating NAT. The gold standard for evaluating the effect of NAT is pathologic response established at surgery. The Miller-Payne grading system was applied to assess the response to NAT. Quantitative parameters were extracted from DLCT, including CT value, normalized CT value, iodine concentration (IC), normalized iodine concentration (NIC), the slope of the spectral Hounsfield unit (HU) curve, effective atomic number, and the normalized effective atomic number. The Mann-Whitney U test was used to compare the distribution differences of DLCT quantitative parameters between the pCR group and the non-pCR group. The diagnostic performance of the quantitative parameters was analyzed by receiver operating characteristic curve.ResultsIn the neoadjuvant chemotherapy group (n=80), compared with the non-pCR group, the slope of the spectral HU curve, IC, effective atomic number, and NIC of arterial phase in the pCR group were higher, and the difference was statistically significant (P<0.05); area under the curve (AUC): 0.768, 0.791, 0.834, and 0.770, respectively. In the neoadjuvant targeted therapy group (n=40), compared with the pCR group, the CT value, IC, effective atomic number, and NIC of the arterial phase in the non-pCR group were higher, and the difference was statistically significant (P<0.05); AUC: 0.844, 0.813, 0.802, and 0.766, respectively. There was no significant difference (P>0.05) in DLCT venous phase quantitative parameters between pCR and non-pCR in 70 patients treated with NAT.ConclusionsThe study suggested a possibility that DLCT provided a potential tool to develop a model for predicting pCR to NAT in BC.

Dataset Information

Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients.

Background

Methods

Results

Conclusions

Publications

Use quantitative parameters in spectral computed tomography for the differential diagnosis of metastatic mediastinal lymph nodes in lung cancer patients.

Similar Datasets

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