Differentiation of malignant cervical lymphadenopathy by dual-energy CT: a preliminary analysis

The accurate diagnosis of malignant cervical lymphadenopathy remains challenging. In this study, we determined the value of quantitative parameters derived from dual-energy computed tomography (DECT) for differentiating malignant cervical lymphadenopathy caused by thyroid carcinoma (TC), salivary gland carcinoma (SC), squamous cell carcinoma (SCC) and lymphoma. We retrospectively analysed 92 patients with pathologically confirmed cervical lymphadenopathy due to TC, SC, SCC and lymphoma. All patients received a DECT scan before therapy. Using GSI (gemstone spectral imaging) Volume Viewer software, we analysed the enhanced monochromatic data, and the quantitative parameters we acquired included the iodine concentration (IC), water concentration (WC) and the slope of the spectral HU curve (lambda(HU)). One-way ANOVA showed significant differences in the IC and lambda(HU) among different groups (P < 0.05). Post-hoc pairwise comparisons demonstrated the IC and lambda(HU) of TC group were significantly higher than those of SC, SCC and lymphoma groups (P < 0.05). In addition, the IC and lambda(HU) of SC group were significantly higher than those of the SCC and lymphoma groups (P < 0.05). Other comparisons of IC and lambda(HU) values showed no significant differences (P > 0.05). The quantitative parameters derived from DECT were useful supplements to conventional computed tomography images and were helpful for distinguishing different malignant cervical lymphadenopathies.