Energy spectrum computed tomography improves the differentiation between benign and malignant solitary pulmonary nodules

Abstract

Purpose: To evaluate the diagnostic efficiency of computed tomography (CT) values at the 40~140 keV monochromatic level for the differential diagnosis of solitary pulmonary nodules (SPNs).
 
 Methods: Energy spectrum CT data of 44 patients with SPNs were analyzed retrospectively; 24 patients with malignant SPNs served as the malignant group
 and 20 patients with benign SPNs served as the benign group. The basic material concentration and the enhancement degree differences in double-phase enhanced scans were compared between the two groups. The sensitivity and specificity were calculated to determine diagnosis, and were compared with the pathology results.
 
 Results: The CT values at the 40~90 keV monochromatic level and the iodine concentrations of malignant group were higher than those of benign group in the arterial phase (all P < 0.05). The enhancement degree of the malignant group was higher than that for the benign group in the arterial phase (36.36 ± 33.18 HU vs 16.93 ± 24.17 HU t = 2.243, P = 0.030); however, the enhancement degrees of the two groups were similar in the venous phase (21.99 ± 15.87 HU vs 17.62 ± 24.15 HU t = 0.694, P = 0.493). The area under the curve of the enhancement degree in the arterial phase was 0.792.
 
 Conclusions: Monochromatic imaging and base material concentration of energy spectrum CT can help differentiate between benign and malignant SPNs.

Comparison of Spectral and Perfusion Computed Tomography Imaging in the Differential Diagnosis of Peripheral Lung Cancer and Focal Organizing Pneumonia

“…To the best of our knowledge, this is the first study to use “one-stop” spectral and perfusion scanning and to compare the diagnostic effectiveness of these two imaging methods. Both spectral and perfusion CT imaging types can distinguish benign from malignant tumors ( 32 ), especially chest tumors ( 14 , 15 , 19 , 33 , 34 ). However, previously reported estimates of diagnostic efficacy have been inconsistent, and the conclusions remain subject to debate.…”

Functionalized Au@Cu-Sb-S Nanoparticles for Spectral CT/Photoacoustic Imaging-Guided Synergetic Photo-Radiotherapy in Breast Cancer

“…Unlike traditional CT, spectral CT decomposes the traditional polyenergetic X-ray beam into continuous single energies ranging from 40 to 140 KeV, which may achieve qualitative separation and quantitative determination of substances. [31][32][33][34][35][36] For example, Metin et al 31 found that the conspicuity of primary breast cancer was significantly higher in low KeV virtual monochromatic images. Thus, the combination of spectral CT and high-Z nanomaterials shows potential for the accurate diagnosis of various diseases.…”