Multiparametric Evaluation of Head and Neck Squamous Cell Carcinoma Using a Single-Source Dual-Energy CT with Fast kVp Switching: State of the Art

Abstract

There is an increasing body of evidence establishing the advantages of dual-energy CT (DECT) for evaluation of head and neck squamous cell carcinoma (HNSCC). Focusing on a single-source DECT system with fast kVp switching, we will review the principles behind DECT and associated post-processing steps that make this technology especially suitable for HNSCC evaluation and staging. The article will review current applications of DECT for evaluation of HNSCC including use of different reconstructions to improve tumor conspicuity, tumor-normal soft tissue interface, accuracy of invasion of critical structures such as thyroid cartilage, and reduce dental artifact. We will provide a practical approach for DECT implementation into routine clinical use and a multi-parametric approach for scan interpretation based on the experience at our institution. The article will conclude with a brief overview of potential future applications of the technique.

Dual-Energy CT Texture Analysis With Machine Learning for the Evaluation and Characterization of Cervical Lymphadenopathy

“…Prediction models were built using either texture data extracted at a single VMI energy of 65 keV, typically considered equivalent and used as a replacement for a conventional 120 kVp single energy neck CT acquisition when a scan is acquired in DECT mode [32,[37], [38], [39], [40]], or multi-energy analysis of the entire 21 VMI datasets [18,[31], [32], [33],41]. Two independent machine learning approaches, the Random Forests (RF) method [42] and Gradient Boosting Machine (GBM) method [43,44] were used to build the prediction models for the different outcomes, consisting of pairwise evaluations of different pathologic lymph nodes and the normal controls.…”

Comparison of MR Imaging and Dual-Energy CT for the Evaluation of Cartilage Invasion by Laryngeal and Hypopharyngeal Squamous Cell Carcinoma

“…Recently, emerging dual-energy CT techniques have been investigated for head and neck cancer imaging with the potential for improved tumor visualization and characterization. [14][15][16][17][18][19][20][21] In particular, techniques using iodine overlay (IO) images were found useful for distinguishing iodine-enhanced tumors from nonossified cartilage 11,14,19,22 and for having higher specificity than conventional CT, without a deterioration of sensitivity, in particular for the evaluation of thyroid cartilage invasion. 14 Furthermore, interobserver agreement is usually poor for conventional CT and was found to be higher for dual-energy CT. 14,23 These new dualenergy CT techniques have prompted re-evaluations of the diagnostic performance of CT compared with MR imaging in diagnostic fields where MR imaging has been routinely used.…”

Advanced Computed Tomography Techniques: Overview of Dual-Energy CT

“…As such, specific reconstructions are used to supplement the standard images for targeted evaluation of a lesion of interest, such as a tumor, in a multiparametric fashion for an optimal diagnostic evaluation. 2,32 This is similar to the way magnetic resonance imaging (MRI) is routinely interpreted by radiologists using information from different sequences for optimal assessment.…”

“…5). 21,24,[28][29][30][31][32][33][34][35][36][37][38][39][40][41] Spectral Hounsfield unit attenuation curves obtained by region of interest (ROI) analysis are a quantitative graphic representation of the energydependent attenuation changes seen on the VMIs (►Fig. 4).…”