European Radiology: Application of dual-energy CT in benign and malignant nasal lesions

There are various benign and malignant tumors and tumor-like lesions in the sinus region
.

Clinically, benign sinus lesions only require surgical resection or follow-up, while malignant sinus lesions generally have a poor prognosis and often require multimodal comprehensive treatment to improve overall survival

There are various benign and malignant tumors and tumor-like lesions in the sinus region

Conventional magnetic resonance imaging (cMRI) can describe the soft tissue part well , and it is the main imaging method to distinguish benign and malignant tumors

Dual-energy CT (DECT) is the latest advancement in CT technology as a functional imaging technique that can display hemodynamic and histological information

Recently, a study published in the journal European Radiology explored the value of DECT in distinguishing benign and malignant sinus lesions by comparing simulated SECT, conventional MRI and DWI, and provided a reference for accurate diagnosis of sinus lesions .
 

In this study , patients with histopathologically confirmed sinus lesions (38 benign and 34 malignant) underwent DECT, cMRI, and DWI

DECT-derived single parameters (IC, Eff-Z, 40 keV, 60 keV, 80 keV, slope (k), Mix-0.
3) were significantly higher in malignant lesions than in benign sinus lesions (all P<0.
004, Bonferroni correction)

 

Figure 66-year-old man with squamous cell carcinoma .

The mass was mainly located in the left nasal cavity (green arrow) .
Compared with benign sinus lesions, it is shown in axial iodine map (a), effective atomic number map (b), spectral decay curve (c), virtual monochromatic 60KeV image (d) and Mix-0.
3 image (simulated SECT) ( e) shows significantly higher IC, Eff-Z, slope (k), 60KeV and Mix-0.

Figure 66-year-old man with squamous cell carcinoma .
The mass was mainly located in the left nasal cavity (green arrow) .
Compared with benign sinus lesions, it is shown in axial iodine map (a), effective atomic number map (b), spectral decay curve (c), virtual monochromatic 60KeV image (d) and Mix-0.
3 image (simulated SECT) ( e) shows significantly higher IC, Eff-Z, slope (k), 60KeV and Mix-0.
3 values .
On conventional MRI, the mass shows heterogeneous iso (tumor cells) to hyperintensity (necrosis) on T2WI (f), with well-defined borders, bony destruction, and heterogeneous moderate enhancement on contrast-enhanced T1WI (g) .

This study demonstrates that DECT-derived quantitative parameters (IC, Eff-Z, 40 keV, 60 keV, 80 keV, slope) are useful in the differential diagnosis of benign and malignant sinus lesions

Original source : Peng Wang Zuohua Tang Zebin Xiao Dual-energy CT in differentiating benign sinonasal lesions from malignant ones: comparison with simulated single-energy CT, conventional MRI, and DWI 10.
1007/s00330-021-08159-3 10.
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