Related Experiment Video
Updated: Nov 19, 2025

Author Spotlight: Integrating Ultrasound Imaging with Biochemical Markers for Thyroid Disease Diagnosis
Published on: February 9, 2024
Could both intrinsic and extrinsic iodine be successfully suppressed on virtual non-contrast CT images for detecting
Arim Park1,2, Young Hen Lee3, Hyung Suk Seo1
1Department of Radiology, Ansan Hospital, Korea University College of Medicine, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, Republic of Korea.
Purpose:
Although virtual non-contrast (VNC) successfully removes iodinated contrast, uncertainty exists regarding the feasibility of VNC to suppress iodine for detecting thyroid calcification. Therefore, we evaluated whether both intrinsic and extrinsic iodine attenuation were suppressed on VNC images.
Material And Methods:
We enrolled 128 patients (male: female 17:111; age 48.0 ± 10.4 years) who underwent dual-layer dual-energy CT (DL-DECT) examination before their thyroid cancer surgeries. Two additional sets of VNC (VNCu, VNCc) images were retrospectively generated from their true unenhanced (TUE) and true contrast-enhanced (TCE) series. We compared CT attenuation values measured on the VNCu and VNCc images by drawing identical regions of interest encompassing thyroid parenchyma, then subjectively determined the concordance of calcification.
Results:
Although CT attenuation discrepancies between the VNCu and VNCc were significant (2.0 ± 5.7HU, p < 0.001),61.7%, 89.1%, and 100.0% of all measurements were < 5HU, < 10HU, and < 15HU. Based on Bland-Altman analysis, the limits of agreement were - 9.2HU and 13.2HU, whereas the proportional differences were small for VNC images generated from both TUE and TCE images. There was no discordance between two VNC image sets in detecting thyroid calcification.
Conclusions:
VNC technique could be a feasible method to suppress both intrinsic and extrinsically administered iodine for detecting thyroid calcification.
Related Concept Videos
Radiological Investigation I: X-ray and CT
Imaging Studies for Cardiovascular System V: CT
Imaging Studies III: Computed Tomography
Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...
Synthesis and Regulation of Thyroid Hormones
Upon reaching the thyroid gland, TSH stimulates the follicular cells' active uptake of iodide ions from the blood. The ions diffuse to the apical surface of the cells and are oxidized to iodine. The...

