Iodine concentration of healthy lymph nodes of neck, axilla, and groin in dual-energy computed tomography

2020 ◽  
Vol 61 (11) ◽  
pp. 1505-1511 ◽  
Author(s):  
Andreas P Sauter ◽  
Sophie Ostmeier ◽  
Jonathan Nadjiri ◽  
Dominik Deniffel ◽  
Ernst J Rummeny ◽  
...  

Background Lymph nodes (LN) are examined in every computed tomography (CT) scan. Until now, an evaluation is only possible based on morphological criteria. With dual-energy CT (DECT) systems, iodine concentration (IC) can be measured which could conduct in an improved diagnostic evaluation of LNs. Purpose To define standard values for IC of cervical, axillary, and inguinal LNs in DECT. Material and Methods Imaging data of 297 patients who received a DECT scan of the neck, thorax, abdomen–pelvis, or a combination of those in a portal-venous phase were retrospectively collected from the institutional PACS. No present history of malignancy, inflammation, or trauma in the examined region was present. For each examined region, the data of 99 patients were used. The IC of the three largest LNs, the main artery, the main vein, and a local muscle of the examined area was measured, respectively. Results Normalization of the IC of LNs to the artery, vein, muscle, or a combination of those did not lead to a decreased value-range. The smallest range and confidence interval (CI) of IC was found when using absolute values of IC for each region. Hereby, mean values (95% CI) for IC of LN were found: 2.09 mg/mL (2.00–2.18 mg/mL) for neck, 1.24 mg/mL (1.16–1.33 mg/mL) for axilla, and 1.11 mg/mL (1.04–1.17 mg/mL) for groin. Conclusion The present study suggests standard values for IC of LNs in dual-layer CT could be used to differentiate between healthy and pathological lymph nodes, considering the used contrast injection protocol.

Author(s):  
David Zopfs ◽  
Josefine Graffe ◽  
Robert Peter Reimer ◽  
Sebastian Schäfer ◽  
Thorsten Persigehl ◽  
...  

Abstract Objectives Dual-energy computed tomography allows for an accurate and reliable quantification of iodine. However, data on physiological distribution of iodine concentration (IC) is still sparse. This study aims to establish guidance for IC in abdominal organs and important anatomical landmarks using a large cohort of individuals without radiological tumor burden. Methods Five hundred seventy-one oncologic, portal venous phase dual-layer spectral detector CT studies of the chest and abdomen without tumor burden at time point of imaging confirmed by > 3-month follow-up were included. ROI were placed in parenchymatous organs (n = 25), lymph nodes (n = 6), and vessels (n = 3) with a minimum of two measurements per landmark. ROI were placed on conventional images and pasted to iodine maps to retrieve absolute IC. Normalization to the abdominal aorta was conducted to obtain iodine perfusion ratios. Bivariate regression analysis, t tests, and ANOVA with Tukey-Kramer post hoc test were used for statistical analysis. Results Absolute IC showed a broad scatter and varied with body mass index, between different age groups and between the sexes in parenchymatous organs, lymph nodes, and vessels (range 0.0 ± 0.0 mg/ml–6.6 ± 1.3 mg/ml). Unlike absolute IC, iodine perfusion ratios did not show dependency on body mass index; however, significant differences between the sexes and age groups persisted, showing a tendency towards decreased perfusion ratios in elderly patients (e.g., liver 18–44 years/≥ 64 years: 0.50 ± 0.11/0.43 ± 0.10, p ≤ 0.05). Conclusions Distribution of IC obtained from a large-scale cohort is provided. As significant differences between sexes and age groups were found, this should be taken into account when obtaining quantitative iodine concentrations and applying iodine thresholds. Key Points • Absolute iodine concentration showed a broad variation and differed between body mass index, age groups, and between the sexes in parenchymatous organs, lymph nodes, and vessels. • The iodine perfusion ratios did not show dependency on body mass index while significant differences between sexes and age groups persisted. • Provided guidance values may serve as reference when aiming to differentiate healthy and abnormal tissue based on iodine perfusion ratios.


2015 ◽  
Vol 205 (5) ◽  
pp. W492-W501 ◽  
Author(s):  
Chiao-Yun Chen ◽  
Jui-Sheng Hsu ◽  
Twei-Shiun Jaw ◽  
Ming-Chen Paul Shih ◽  
Lo-Jeh Lee ◽  
...  

2020 ◽  
Vol 71 (3) ◽  
pp. 371-387 ◽  
Author(s):  
Saira Hamid ◽  
Savvas Nicolaou ◽  
Faisal Khosa ◽  
Gordon Andrews ◽  
Nicolas Murray ◽  
...  

Abdominal trauma, one of the leading causes of death under the age of 45, can be broadly classified into blunt and penetrating trauma, based on the mechanism of injury. Blunt abdominal trauma usually results from motor vehicle collisions, fall from heights, assaults, and sports and is more common than penetrating abdominal trauma, which is usually seen in firearm injuries and stab wounds. In both blunt and penetrating abdominal trauma, an optimized imaging approach is mandatory to exclude life-threatening injuries. Easy availability of the portable ultrasound in the emergency department and trauma bay makes it one of the most commonly used screening imaging modalities in the abdominal trauma, especially to exclude hemoperitoneum. Evaluation of the visceral and vascular injuries in a hemodynamically stable patient, however, warrants intravenous contrast-enhanced multidetector computed tomography scan. Dual-energy computed tomography with its postprocessing applications such as iodine selective imaging and virtual monoenergetic imaging can reliably depict the conspicuity of traumatic solid and hollow visceral and vascular injuries.


2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Hayato Tomita ◽  
Hirofumi Kuno ◽  
Kotaro Sekiya ◽  
Katharina Otani ◽  
Osamu Sakai ◽  
...  

Background and Objectives. Thyroid nodules are increasingly being detected during cross-sectional imaging of the neck and chest. The purpose of this study is to investigate the efficacy of dual-energy computed tomography (DECT) using iodine concentration measurement and multiparametric texture analysis of monochromatic images for differentiating between benign and malignant thyroid nodules. Materials and Methods. This retrospective study included 34 consecutive patients who presented with thyroid nodules and underwent noncontrast DECT between 2015 and 2016. Manual segmentation of each thyroid nodule by monochromatic imaging (40, 60, and 80 keV) was performed, and an in-house developed MATLAB-based texture analysis program was used to extract 41 textures. Iodine material decomposition and CT attenuation slopes were also measured. Histopathologic findings of ultrasound-guided biopsies over a follow-up period of at least one year were used as reference standards. Basic descriptive statistics and areas under receiver operating characteristic curves (AUCs) were evaluated. Results. The 34 nodules comprised 14 benign nodules and 20 malignant nodules. Iodine content and Hounsfield unit curve slopes did not differ significantly between benign and malignant thyroid nodules (P=0.480–0.670). However, significant differences in the texture features of monochromatic images were observed between benign and malignant nodules: histogram mean and median, co-occurrence matrix contrast, gray-level gradient matrix (GLGM) skewness, and mean gradients and variance of gradients for GLGM at 80 keV (P=0.014–0.044). The highest AUC was 0.77, for the histogram mean and median of images acquired at 80 keV. Conclusions. Texture features extracted from monochromatic images using DECT, specifically acquired at high keV, may be a promising diagnostic approach for thyroid nodules. A further large study for incidental thyroid nodules using DECT texture analysis is required to validate our results.


Medicine ◽  
2016 ◽  
Vol 95 (39) ◽  
pp. e4816 ◽  
Author(s):  
Shun-Yu Gao ◽  
Xiao-Yan Zhang ◽  
Wei Wei ◽  
Xiao-Ting Li ◽  
Yan-Ling Li ◽  
...  

2019 ◽  
Vol 213 (3) ◽  
pp. 619-625 ◽  
Author(s):  
Nima Sadoughi ◽  
Satheesh Krishna ◽  
David B. Macdonald ◽  
Robert Chatelain ◽  
Trevor A. Flood ◽  
...  

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