Dual-Energy Computed Tomography-Derived Iodine Density and Spectral Attenuation Analysis for Differentiation of Inverted Papilloma and Sinonasal Squamous Cell Carcinoma/Lymphoma
Issued Date
2022-11-01
Resource Type
ISSN
03638715
eISSN
15323145
Scopus ID
2-s2.0-85142402330
Pubmed ID
36326873
Journal Title
Journal of Computer Assisted Tomography
Volume
46
Issue
6
Start Page
953
End Page
960
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Computer Assisted Tomography Vol.46 No.6 (2022) , 953-960
Suggested Citation
Tunlayadechanont P., Tritanon O., Chansakul T., Pureepatipat S. Dual-Energy Computed Tomography-Derived Iodine Density and Spectral Attenuation Analysis for Differentiation of Inverted Papilloma and Sinonasal Squamous Cell Carcinoma/Lymphoma. Journal of Computer Assisted Tomography Vol.46 No.6 (2022) , 953-960. 960. doi:10.1097/RCT.0000000000001370 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/85389
Title
Dual-Energy Computed Tomography-Derived Iodine Density and Spectral Attenuation Analysis for Differentiation of Inverted Papilloma and Sinonasal Squamous Cell Carcinoma/Lymphoma
Author's Affiliation
Other Contributor(s)
Abstract
Objective This study aimed to assess the value of dual-energy computed tomography for differentiation of inverted papilloma from squamous cell carcinoma (SCC)/lymphoma. Methods Twenty-eight patients with pathologically diagnosed inverted papilloma or SCC/lymphoma underwent contrast-enhanced dual-energy computed tomography. Qualitative features (laterality, location, enhancement pattern, border, necrosis, hemorrhage, calcification, bone destruction, pterygopalatine fossa extension, adjacent invasion, and perineural spreading) and quantitative features (iodine density and spectral attenuation curve slope) were analyzed. Optimal cutoff thresholds of diagnostic efficacy were generated. Results Fifteen patients had inverted papilloma, and 13 had malignancy (5 SCC and 8 lymphoma). Computed tomography findings of bilateral lesions, sphenoid sinus involvement, pterygopalatine fossa extension, and adjacent invasion were significantly associated with SCC/lymphoma. The iodine density was significantly higher in SCC/lymphoma (2.46 ± 0.22 mg/mL) than in inverted papilloma (1.42 ± 0.46 mg/mL; P = 0.001). An iodine density threshold of 1.74 mg/mL had a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 92.3%, 86.7%, 92.9%, 85.7%, and 90.3%, respectively. The spectral attenuation curve slope was significantly higher in SCC/lymphoma (4.35 ± 0.27 HU/keV) than in inverted papilloma (2.72 ± 0.88 HU/keV; P = 0.001). A spectral attenuation curve slope threshold of 3.34 HU/keV had a sensitivity, specificity, negative predictive value, positive predictive value, and accuracy of 92.3%, 86.7%, 92.9%, 85.7%, and 90.8%, respectively. Conclusions Squamous cell carcinoma/lymphoma had a significantly higher iodine density and spectral attenuation curve slope than inverted papilloma. Using optimal quantitative measurement thresholds provides high diagnostic efficacy.