ArticleJournal of computer assisted tomography
Dual-Energy Computed Tomography-Derived Iodine Density and Spectral Attenuation Analysis for Differentiation of Inverted Papilloma and Sinonasal Squamous Cell Carcinoma/Lymphoma.
Article in Journal of computer assisted tomography. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors at 1 institution in 2 countries.
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Abstract
objectiveThis study aimed to assess the value of dual-energy computed tomography for differentiation of inverted papilloma from squamous cell carcinoma (SCC)/lymphoma.
methodsTwenty-eight patients with pathologically diagnosed inverted papilloma or SCC/lymphoma underwent contrast-enhanced dual-energy computed tomography. Qualitative features (laterality, location, enhancement pattern, border, necrosis, hemorrhage, calcification, bone destruction, pterygopalatine fossa extension, adjacent invasion, and perineural spreading) and quantitative features (iodine density and spectral attenuation curve slope) were analyzed. Optimal cutoff thresholds of diagnostic efficacy were generated.
resultsFifteen patients had inverted papilloma, and 13 had malignancy (5 SCC and 8 lymphoma). Computed tomography findings of bilateral lesions, sphenoid sinus involvement, pterygopalatine fossa extension, and adjacent invasion were significantly associated with SCC/lymphoma. The iodine density was significantly higher in SCC/lymphoma (2.46 ± 0.22 mg/mL) than in inverted papilloma (1.42 ± 0.46 mg/mL; P = 0.001). An iodine density threshold of 1.74 mg/mL had a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 92.3%, 86.7%, 92.9%, 85.7%, and 90.3%, respectively. The spectral attenuation curve slope was significantly higher in SCC/lymphoma (4.35 ± 0.27 HU/keV) than in inverted papilloma (2.72 ± 0.88 HU/keV; P = 0.001). A spectral attenuation curve slope threshold of 3.34 HU/keV had a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 92.3%, 86.7%, 92.9%, 85.7%, and 90.8%, respectively.
conclusionsSquamous cell carcinoma/lymphoma had a significantly higher iodine density and spectral attenuation curve slope than inverted papilloma. Using optimal quantitative measurement thresholds provides high diagnostic efficacy.
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