Diagnostic Effectiveness of Dual Source Dual Energy Computed Tomography for Benign and Malignant Thyroid Nodules

Abstract

Objective: To evaluate the diagnostic effectiveness of dual source dual energy computed tomography (DS-DECT) for benign and malignant thyroid nodules.

Methods: Between January 2019 and December 2021, 60 patients with surgically and pathologically verified thyroid nodules treated at our institution were recruited. DS-DECT was administered to all patients. The iodine content of lesioned and normal tissues, the normalized iodine concentration (NIC) and standardized CT values of benign and malignant nodules, the consistency of examination results and pathological findings, and diagnostic effectiveness were all investigated.

Results: The diagnosis accuracy was the same as that of surgical pathology, producing a 100% accuracy for the 60 patients with thyroid nodules (42 were benign and 18 were malignant). The iodine content of lesioned solid tissue differed significantly from that of normal tissue, as did the iodine content of malignant and benign nodules (P < 0.05). In the arterial phase, no significant difference was found in NIC and standardized CT values between benign and malignant nodules (P > 0.05). The optimal critical NIC for differentiating benign and malignant nodules in the venous phase was 0.74 and the standardized CT value was 0.79 HU according to the receiver operating characteristics (ROC) curve. Malignant nodules were diagnosed when the NIC was <0.74 and the standardized CT value was <0.79 HU, with AUC values of 0.89 and 0.93, respectively, where the sensitivity and specificity of the differential diagnosis of NIC were 90.48% (38/42) and 88.89% (16/18), respectively, and those of the differential diagnosis of standardized CT value were 92.86% (39/ 42) and 94.44% (17/18), respectively. The diagnosis accuracy of DS-DECT was 100%, and the diagnostic results of morphological characteristics and pathological testing were consistent. The sensitivity and specificity of the NIC values and standardized CT values in the venous phase differential diagnosis of benign and malignant nodules were compatible with the morphological differential diagnosis.

Conclusion: DS-DECT is highly accurate in determining the benignity and malignancy of thyroid nodules and has a strong potential for clinical promotion to allow for prompt treatment.