Diagnostic value of single-source dual-energy spectral computed tomography in differentiating parotid gland tumors: initial results

摘要

Background: An accurate preoperative diagnosis that helps distinguish between benign and malignant parotid gland tumors is very important because the results strongly affect surgical procedures. We aimed to evaluate the value of single-source dual-energy computed tomography (ssDECT) in differentiating malignant from benign parotid gland tumors. Methods: Fifty patients underwent enhanced neck ssDECT scanning before surgery. The images were analyzed using the gemstone spectral imaging (GSI) viewer software. Results: Fifty-two tumors (43 patients) were con?rmed histopathologically, comprising of 12 pleomorphic adenomas (PAs), 24 Warthin tumors (WTs) (15 patients), and 16 malignant tumors (MTs). The iodine concentration (IC), normalized iodine concentration to common carotid artery (NIC A ) and slope value of the spectral curve (λ HU ) of the WTs were signi?cantly higher than those of MTs and PAs (all P A and λ HU thresholds for differentiating PAs from MTs were 0.91 mg/mL, 0.15 and 1.09, respectively, achieving sensitivities of 91.7%, 91.7% and 91.7%, speci?cities of 95.0%, 85.0% and 95.0%, and accuracies of 94.2%, 86.5% and 94.2%, respectively for distinguishing PAs from MTs. The optimal IC, NIC A and λ HU thresholds for distinguishing WTs from MTs were 1.46 mg/mL, 0.20 and 1.72, achieving sensitivities of 91.7%, 95.8% and 91.7%, and speci?cities of 89.3%, 85.7% and 89.3%, respectively. The accuracy was 90.4%, 90.4% and 90.4%, respectively. Conclusions: The parameters of ssDECT in enhanced CT scans are useful in the differential diagnosis of parotid tumors.