Dual-energy CT iodine concentration differentiates lung cancer from pulmonary metastases (Doctor just needs to look for “rings” in image)

Medical Xpress / American Roentgen Ray Society / American Journal of Roentgenology ^ | Jan. 11, 2023 | Yoshinao Sato et al

[ConservativeMind]

According to an accepted manuscript, ringlike peripheral high iodine concentration maps from dual-energy CT (DECT) can help guide management in patients with known lung cancer and an indeterminate solitary nodule.

"Ringlike peripheral high iodine concentration had excellent interobserver agreement, showed high specificity (albeit poor sensitivity) for differentiating pulmonary metastasis from primary lung cancer, and independently predicted pulmonary metastasis," wrote first author Yoshinao Sato, MD, Ph.D.

This study included 93 patients (64 men, 29 women; median age, 70 years) who underwent resection of a primary lung cancer (n=68) or pulmonary metastasis (n=25) corresponding with a solid lesion on preoperative contrast-enhanced DECT performed between April 2020 and March 2021. After constructing venous-phase 120-keV single-energy images, equilibrium-phase 66-keV virtual monoenergetic images, as well as iodine concentration maps, two radiologists independently assessed lesions for the following: spiculated margins, air bronchograms, rim enhancement, and thin ringlike peripheral high iodine concentration.

Ultimately, ringlike peripheral high iodine concentration on DECT showed excellent interobserver agreement (κ=0.80), and had sensitivity of 52% and specificity of 81% for differentiating pulmonary metastases from primary lung cancers. Additionally, the finding independently predicted pulmonary metastasis in multivariate analysis [OR=7.81, 95% CI: 2.28–29.60; p=.001] combining patient and lesion characteristics.

"Iodine concentration maps from DECT could help determine the diagnosis for lesions that are equivocal for pulmonary metastasis on conventional images," write the researchers.

[ConservativeMind]

Pictures for your radiologist or yourself, when you get a copy on DVD, at the link.

[ConservativeMind]

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[nickcarraway]

Are we humans or trees?

[Bob434]

i caught pneumonia once, and it left white spots on the lungs- Docs said it was cancer caused by the pneumonia- darn near operated and removed a chunk of lung, but at last minute practically i got nervous and asked for a biopsy to make sure- they were reluctant, but did so- they said they took several samples- came back and said “We don’t know what it is, but we do know that it’s not cancer” - they called off the surgery 3 days before i was due in- and i went home, and the spots just slowly cleared up- That was too close for comfort!

[xenia]

I picked the link and read the article. I have no clue what they are talking about. What is it saying?

My sister has lung cancer and I was hoping for some helpful info.

[Tunehead54]

Ping to PC & all