Related Experiment Video
Updated: Jun 1, 2025
Three-Dimensional Imaging of the Vertebral Lymphatic Vasculature and Drainage using iDISCO+ and Light Sheet Fluorescence Microscopy
Published on: May 22, 2020
Iodine Density of Lymphoma, Metastatic SCCA, and Normal Cervical lymph nodes: A Comparative Analysis Based on DLSCT
Varalee Mingkwansook1, Urusaya Wangprasertkul1, Warit Tarathipmon1
1Radiology, Thammasat University, meung, pathumtani, 12000, Thailand.
Insights
Dual-layer spectral CT effectively differentiates lymphomatous from metastatic SCCA and normal cervical lymph nodes using iodine density and contrast-enhanced attenuation values. This imaging technique aids in diagnosing cervical lymph node conditions.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Cervical lymph node assessment is crucial for diagnosing lymphoma and metastatic squamous cell carcinoma (SCCA).
- Distinguishing between lymphomatous, metastatic SCCA, and normal lymph nodes can be challenging with conventional imaging.
- Dual-layer spectral computed tomography (DLSCT) offers advanced material decomposition capabilities.
Purpose of the Study:
- To compare iodine density (ID) and contrast-enhanced attenuation value (CEAV) from DLSCT scans of lymphomatous, metastatic SCCA, and normal cervical lymph nodes.
- To evaluate the diagnostic performance of DLSCT parameters in differentiating these cervical lymph node groups.
- To establish optimal cut-off values for ID and CEAV in distinguishing between lymphomatous and metastatic SCCA nodes.
Main Methods:
- Retrospective analysis of DLSCT neck scans from January 2020 to August 2023.
- Inclusion of 129 cervical lymph nodes: 50 lymphomatous, 41 metastatic SCCA, and 38 normal.
- Statistical analysis using one-way ANOVA and receiver operating characteristic (ROC) curve analysis.
Main Results:
- Mean ID was significantly lower in lymphomatous nodes (1.01±0.27 mg/mL) compared to metastatic SCCA (1.36±0.28 mg/mL) and normal nodes (1.45±0.29 mg/mL).
- Mean CEAV was also significantly lower in lymphomatous nodes compared to metastatic SCCA and normal nodes (p<0.001 for both comparisons).
- Optimal ID cut-off: 1.175 mg/mL (AUC 0.788); Optimal CEAV cut-off: 77.5 HU (AUC 0.851) for distinguishing lymphomatous from metastatic SCCA nodes.
Conclusions:
- DLSCT-derived ID and CEAV measurements show significant differences between lymphomatous, metastatic SCCA, and normal cervical lymph nodes.
- These quantitative DLSCT parameters can effectively distinguish between these conditions.
- DLSCT holds promise as a valuable tool for the diagnosis and characterization of cervical lymph node pathologies.
Objective:
To compare iodine density (ID) and contrast-enhanced attenuation value (CEAV) from dual-layer spectral computed tomography (DLSCT) scans of lymphomatous, metastatic squamous cell carcinoma (SCCA), and normal cervical lymph nodes.
Methods:
Data including ID and CEAV were retrospectively collected from patients who underwent DLSCT of the neck between January 2020 and August 2023. Results from each group (lymphomatous, metastatic SCCA, and normal) were compared and analyzed using one-way ANOVA and receiver operating characteristic curve.
Results:
129 cervical lymph nodes were collected from patients who met the inclusion criteria (50, 41, and 38 nodes from the lymphomatous, metastatic SCCA, and normal group, respectively). The mean ID of lymphomatous, metastatic SCCA, and normal nodes was 1.01±0.27, 1.36±0.28, and 1.45±0.29 mg/mL, respectively. Comparing lymphomatous nodes with metastatic SCCA nodes, the lymphomatous nodes had significantly lower values of ID (p<0.002) and CEAV (p<0.001). Similarly, when comparing lymphomatous nodes with normal nodes, the lymphomatous nodes had significantly lower values of ID (p<0.001) and CEAV (p<0.001). The optimal ID cut-off value for distinguishing between lymphomatous and metastatic SCCA nodes was 1.175 mg/ml (specificity of 84.2%, sensitivity 77.8%, AUC 0.788, P = 0.003). The optimal CEAV cut-off value was 77.5 HU (specificity 88.9%, sensitivity 78.9%, AUC 0.851, P<0.001).
Conclusions:
The ID and CEAV measurements from DLSCT were significantly different between lymphomatous, metastatic SCCA, and normal lymph nodes. These findings indicate that DLSCT can be used to distinguish between these conditions in the diagnosis of cervical lymph nodes.
