Thyroid nodule characterization using Spectral Detector Computed Tomography (SDCT) in comparison to ultrasound

Area of Science:

• Radiology
• Medical Imaging
• Oncology

Background:

• Thyroid nodules are common, and accurate risk stratification is crucial for patient management.
• Ultrasound (US) with Thyroid Imaging Reporting and Data System (TI-RADS) is standard for initial evaluation.
• Advanced imaging techniques are being explored to improve nodule characterization.

Purpose of the Study:

• To evaluate the utility of Spectral Detector computed tomography (SDCT) in characterizing thyroid nodules.
• To correlate SDCT spectral properties with TI-RADS categories determined by US.
• To assess if SDCT can help differentiate between low-risk and intermediate-high risk thyroid nodules.

Main Methods:

• Retrospective analysis of patients undergoing both US and contrast-enhanced SDCT of the neck/thorax (2018-2020).
• Nodules were categorized using TI-RADS on US (TI-RADS 2-3 vs. TI-RADS 4-5).
• SDCT spectral data including Iodine concentration, spectral slope, and enhancement were measured and compared between TI-RADS groups.

Main Results:

• Thirty-eight thyroid nodules were analyzed.
• Nodules in the intermediate-high risk TI-RADS 4-5 group showed significantly higher Iodine concentration (4.6 vs. 2.3 mg/ml), estimated enhancement (3.9 vs. 2.2), and spectral slope (5.6 vs. 2.9) compared to the low-risk TI-RADS 2-3 group (p < 0.001).

Conclusions:

• SDCT spectral analysis provides valuable quantitative data for thyroid nodule characterization.
• These findings suggest SDCT can aid in differentiating intermediate-high risk thyroid nodules from low-risk ones.
• SDCT offers supplementary information beyond conventional imaging for improved thyroid nodule assessment.