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Preoperative prediction of lymph node status in oral squamous cell carcinoma: value of quantitative dual-energy CT parameters

  • 0Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, People's Republic of China.
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology +

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September 25, 2025

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September 25, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Dual-energy computed tomography (DECT) parameters from primary oral squamous cell carcinoma lesions can predict cervical lymph node metastasis. Specific DECT metrics like spectral slope (λHU) and effective atomic number (Zeff) show diagnostic potential.

Area Of Science

  • Oncology
  • Radiology
  • Medical Imaging

Background

  • Oral squamous cell carcinoma (OSCC) frequently metastasizes to cervical lymph nodes (LNs), impacting prognosis.
  • Accurate staging of cervical LNs is crucial for OSCC treatment planning.
  • Dual-energy computed tomography (DECT) offers advanced imaging capabilities beyond conventional CT.

Purpose Of The Study

  • To investigate the utility of DECT quantitative parameters derived from primary OSCC lesions for evaluating cervical LN status.
  • To identify specific DECT metrics that can predict lymph node metastasis, lymph node ratio (LNR), and lymph node burden (LNB).

Main Methods

  • Retrospective analysis of DECT scans and pathological data from 121 OSCC patients who underwent neck dissection.
  • Quantitative DECT parameters (λHU, IC, Rho, NIC, Zeff) were measured in primary lesions.
  • Logistic regression and ROC curve analysis were employed to assess diagnostic performance and identify independent predictors.

Main Results

  • The spectral slope (λHU) in the venous phase was an independent predictor of LN metastasis (AUC=0.812).
  • Precontrast effective atomic number (Zeff) was higher in patients with high metastatic LNB.
  • Precontrast Zeff independently predicted high LNR (AUC=0.726).

Conclusions

  • Quantitative DECT parameters from primary OSCC lesions show promise in evaluating cervical LN status.
  • DECT metrics can aid in non-invasively assessing the risk of lymph node metastasis in OSCC patients.