Metastatic and non-metastatic lymph nodes

quantification and different distribution of iodine uptake assessed by dual-energy CT

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

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13 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)760-769
Number of pages10
JournalEuropean Radiology
Volume28
Issue number2
DOIs
Publication statusPublished - Feb 1 2018

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Iodine
Lymph Nodes
Observer Variation

Keywords

  • Computed tomography
  • Iodine
  • Lymph nodes
  • Lymphatic metastasis
  • Tissue distribution

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{3ea73e10815a4749a3f0a6298ff085fe,
title = "Metastatic and non-metastatic lymph nodes: quantification and different distribution of iodine uptake assessed by dual-energy CT",
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.",
keywords = "Computed tomography, Iodine, Lymph nodes, Lymphatic metastasis, Tissue distribution",
author = "Stefania Rizzo and Davide Radice and Marco Femia and {De Marco}, Paolo and Daniela Origgi and Lorenzo Preda and Massimo Barberis and Raffaella Vigorito and Giovanni Mauri and Alberto Mauro and Massimo Bellomi",
year = "2018",
month = "2",
day = "1",
doi = "10.1007/s00330-017-5015-5",
language = "English",
volume = "28",
pages = "760--769",
journal = "European Radiology",
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TY - JOUR

T1 - Metastatic and non-metastatic lymph nodes

T2 - quantification and different distribution of iodine uptake assessed by dual-energy CT

AU - Rizzo, Stefania

AU - Radice, Davide

AU - Femia, Marco

AU - De Marco, Paolo

AU - Origgi, Daniela

AU - Preda, Lorenzo

AU - Barberis, Massimo

AU - Vigorito, Raffaella

AU - Mauri, Giovanni

AU - Mauro, Alberto

AU - Bellomi, Massimo

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

AB - 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.

KW - Computed tomography

KW - Iodine

KW - Lymph nodes

KW - Lymphatic metastasis

KW - Tissue distribution

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U2 - 10.1007/s00330-017-5015-5

DO - 10.1007/s00330-017-5015-5

M3 - Article

VL - 28

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EP - 769

JO - European Radiology

JF - European Radiology

SN - 0938-7994

IS - 2

ER -