Dual-energy computed tomography as a lower radiation dose alternative to perfusion computed tomography in tumor viability assessment

Abstract

To present the utility of dual-energy computed tomography (DECT) in the assessment of angiogenesis of focal lesions as an example of a solitary pulmonary nodule (SPN). This prospective study comprised 28 patients with SPN who underwent DECT and perfusion computed tomography (CTP), according to a proprietary protocol. Two radiologists independently analyzed four perfusion parameters, namely blood flow (BF), blood volume (BV), the time to maximum of the tissue residue function (Tmax), permeability surface area product (PS) from CTP, in addition to the iodine concentration (IC) and normalized iodine concentration (NIC) of the SPN from DECT. We used the Pearson R correlation and interclass correlation coefficients (ICCs). Statistical significance was assumed at p < 0.05. The mean tumor size was 23.5 ± 6.5 mm. We observed good correlations between IC and BF (r = 0.78, p < 0.000) and NIC and BF (r = 0.71, p < 0.000) as well as between IC and BV (r = 0.73, p < 0.000) and NIC and BV (r = 0.73, p < 0.000) and poor correlation between IC and PS (r = 0.38, p = 0.044).There was no correlation between NIC and PS (r = 0.35, p = 0.064), IC content and Tmax (r = − 0.28, p = 0.147) and NIC and Tmax (r = − 0.21, p = 0.266). Inter-reader agreement on quantitative parameters at CTP (ICCPS = 0.97, ICCTmax = 0.96, ICCBV = 0.98, and ICCBF = 0.99) and DECT (ICCIC = 0.98) were excellent. The radiation dose was significantly lower in DECT than that in CTP (4.84 mSv vs. 9.07 mSv, respectively). DECT is useful for the functional assessment of oncological lesions with less exposure to radiation compared to perfusion computed tomography.

Assessment of Computed Tomography Perfusion Research Landscape: A Topic Modeling Study

“…CTP has revealed marked disparities in perfusion values between normal and neoplastic tissues, with notably elevated perfusion metrics observed in patients with head and neck, rectal, hepatic, and lung masses [10]. Consequently, this assessment plays a pivotal role in diagnosing and staging, prognosticating, and tracking responses to therapies [11]. In more specific terms, for certain tumor types, CTP has proven effective in differentiating between benign and malignant processes [12][13][14], forecasting potential metastatic events [15], predicting therapeutic responses [16,17], and monitoring responses to various treatments [18][19][20][21][22].…”