Spectral CT Imaging of Laryngeal and Hypopharyngeal Squamous Cell Carcinoma: Evaluation of Image Quality and Status of Lymph Nodes

PURPOSE The purpose of this study was to evaluate image quality and status of lymph nodes in laryngeal and hypopharyngeal squamous cell carcinoma (SCC) patients using spectral CT imaging. MATERIALS AND METHODS Thirty-eight patients with laryngeal and hypopharyngeal SCCs were scanned with spectral CT mode in venous phase. The conventional 140-kVp polychromatic images and one hundred and one sets of monochromatic images were generated ranging from 40 keV to 140 keV. The mean optimal keV was calculated on the monochromatic images. The image quality of the mean optimal keV monochromatic images and polychromatic images was compared with two different methods including a quantitative analysis method and a qualitative analysis method. The HU curve slope (λHU) in the target lymph nodes and the primary lesion was calculated respectively. The ratio of λHU was studied between metastatic and non-metastatic lymph nodes group. RESULTS A total of 38 primary lesions were included. The mean optimal keV was obtained at 55 ± 1.77 keV on the monochromatic images. The image quality evaluated by two different methods including a quantitative analysis method and a qualitative analysis method was obviously increased on monochromatic images than polychromatic images (p<0.05). The ratio of λHU between metastatic and non-metastatic lymph nodes was significantly different in the venous phase images (p<0.05). CONCLUSION The monochromatic images obtained with spectral CT can be used to improve the image quality of laryngeal and hypopharyngeal SCC and the N-staging accuracy. The quantitative ratio of λHU may be helpful for differentiating between metastatic and non-metastatic cervical lymph nodes.