European Radiology: Dual-energy CT to distinguish benign and malignant nasal cavity lesions

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

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

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

Conventional magnetic resonance imaging (cMRI) can provide a good description of soft tissues and is the main imaging method to distinguish benign and malignant tumors

Dual-energy CT (DECT) is the latest development of CT technology and can be used as a functional imaging technology to display hemodynamic and histological information

Recently, published in the E uropean a journal Radiology study by comparing simulation SECT, conventional MRI and DWI, explore the DECT value in distinguishing benign and malignant lesions of the sinuses , provide a reference for the accurate diagnosis of sinus disease .
 

In this study , DECT, cMRI and DWI were performed on patients with sinus disease confirmed by histopathology (38 benign and 34 malignant) .
Use t-test or chi-square test for DECT-derived parameters (iodine concentration (IC), effective atom number (Eff-Z), 40-180keV (20keV interval), virtual non-enhancement (VNC), slope (k) and linear mixture 0.
3 (Mix-0.
3)), DECT morphological characteristics, cMRI characteristics, and ADC values ​​of benign and malignant tumors were compared .

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

 

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

The mass is mainly located in the left nasal cavity (green arrow) .
Compared with healthy sinus disease, it is in the axial position of iodine FIG (A), FIG effective atomic number (B), the spectral attenuation curve (C), a virtual 60KeV monochrome image (d) and Mix-0.
3 image (analog 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 is mainly located in the left nasal cavity (green arrow) .
Compared with healthy sinus disease, it is in the axial position of iodine FIG (A), FIG effective atomic number (B), the spectral attenuation curve (C), a virtual 60KeV monochrome image (d) and Mix-0.
3 image (analog SECT) ( e) shows significantly higher IC, Eff-Z, slope (k), 60KeV and Mix-0.
3 values .
On conventional MRI, the mass showed unevenness (tumor cells) to high signal (necrosis) on T2WI (f) , clear boundaries, bone destruction, and uneven medium enhancement on T1WI (g).

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

Original source : Peng Wang Zuohua Tang Zebin Xiao 10.
1007/s00330-021-08159-3 10.
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