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01-02-2018 | Computed Tomography

Metastatic and non-metastatic lymph nodes: quantification and different distribution of iodine uptake assessed by dual-energy CT

Authors: Stefania Rizzo, Davide Radice, Marco Femia, Paolo De Marco, Daniela Origgi, Lorenzo Preda, Massimo Barberis, Raffaella Vigorito, Giovanni Mauri, Alberto Mauro, Massimo Bellomi

Published in: European Radiology | Issue 2/2018

Abstract

Objectives

To evaluate quantification of iodine uptake in metastatic and non-metastatic lymph nodes (LNs) by dual-energy CT (DECT) and to assess if the distribution of iodine within LNs at DECT correlates with the pathological structure.

Methods

Ninety LNs from 37 patients (23 with lung and 14 with gynaecological malignancies) were retrospectively selected. Information of LNs sent for statistical analysis included Hounsfield units (HU) at different energy levels; decomposition material densities fat–iodine, iodine–fat, iodine–water, water–iodine. Statistical analysis included evaluation of interobserver variability, material decomposition densities and spatial HU distribution within LNs.

Results

Interobserver agreement was excellent. There was a significant difference in iodine–fat and iodine–water decompositions comparing metastatic and non-metastatic LNs (p < 0.001); fat–iodine and water–iodine did not show significant differences. HU distribution showed a significant gradient from centre to periphery within non-metastatic LNs that was significant up to 20–30% from the centre, whereas metastatic LNs showed a more homogeneous distribution of HU, with no significant gradient.

Conclusions

DECT demonstrated a lower iodine uptake in metastatic compared to non-metastatic LNs. Moreover, the internal iodine distribution showed an evident gradient of iodine distribution from centre to periphery in non-metastatic LNs, and a more homogeneous distribution within metastatic LNs, which corresponded to the pathological structure.

Key points

• This study demonstrated a lower iodine uptake in metastatic than non-metastatic LNs.

• Internal distribution of HU was different between metastatic and non-metastatic lymph nodes.

• The intranodal iodine distribution disclosed a remarkable correlation with the histological LN structure.

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Title: Metastatic and non-metastatic lymph nodes: quantification and different distribution of iodine uptake assessed by dual-energy CT
Authors: Stefania Rizzo
Davide Radice
Marco Femia
Paolo De Marco
Daniela Origgi
Lorenzo Preda
Massimo Barberis
Raffaella Vigorito
Giovanni Mauri
Alberto Mauro
Massimo Bellomi
Publication date: 01-02-2018
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 2/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-017-5015-5

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Metastatic and non-metastatic lymph nodes: quantification and different distribution of iodine uptake assessed by dual-energy CT

Abstract

Objectives

Methods

Results

Conclusions

Key points

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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