フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Dual-Energy CT-Derived Electron Density for Diagnosing Metastatic Mediastinal Lymph Nodes in Non-Small Cell Lung Cancer: Comparison With Conventional CT and FDG PET/CT Findings.
掲載誌名	正式名：AJR. American journal of roentgenology 略　 称：AJR Am J Roentgenol ISSNコード：15463141/0361803X
掲載区分	国外
巻・号・頁	218(1),pp.66-74
著者・共著者	Hiroaki Nagano, Koji Takumi, Masatoyo Nakajo, Yoshihiko Fukukura, Yuichi Kumagae, Megumi Jinguji, Atsushi Tani, Takashi Yoshiura
発行年月	2022/01
概要	BACKGROUND. Accurate nodal staging is essential to guide treatment selection in patients with non-small cell lung cancer (NSCLC). To our knowledge, measurement of electron density (ED) using dual-energy CT (DECT) is unexplored for this purpose. OBJECTIVE. The purpose of our study was to assess the utility of ED from DECT in diagnosing metastatic mediastinal lymph nodes in patients with NSCLC in comparison with conventional CT and FDG PET/CT. METHODS. This retrospective study included 57 patients (36 men, 21 women; mean age, 68.4 ± 8.9 [SD] years) with NSCLC and surgically resected mediastinal lymph nodes who underwent preoperative DECT and FDG PET/CT. The patients had a total of 117 resected mediastinal lymph nodes (33 metastatic, 84 nonmetastatic). Two radiologists independently reviewed the morphologic features of nodes on the 120-kVp images and also measured the iodine concentration (IC) and ED of nodes using maps generated from DECT data; consensus was reached for discrepancies. Two different radiologists assessed FDG PET/CT examinations in consensus for positive node uptake. Diagnostic performance was evaluated for individual and pairwise combinations of features. RESULTS. The sensitivity, specificity, and accuracy for nodal metastasis were 15.2%, 98.8%, and 75.2% for the presence of necrosis, respectively; 54.5%, 85.7%, and 76.9% for short-axis diameter greater than 8.5 mm; 63.6%, 73.8%, and 70.9% for long-axis diameter greater than 13.0 mm; 51.5%, 79.8%, and 71.8% for attenuation on 120-kVp images of 95.8 HU or less; 87.9%, 58.3%, and 66.7% for ED of 3.48 × 1023/cm3 or less; and 66.7%, 75.0%, and 72.6% for positive FDG uptake. Among pairwise combinations of features, accuracy was highest for the combination of ED and short-axis diameter (accuracy, 82.9%; sensitivity, 54.5%; specificity, 94.0%) and the combination of ED and positive FDG uptake (accuracy, 82.1%; sensitivity, 60.6%; specificity, 90.5%); these accuracies were greater than those for the individual
DOI	10.2214/AJR.21.26208
PMID	34319164