title: Can virtual non-enhanced CT be used to replace true non-enhanced CT for the detection of palpable cervical lymph nodes? A preliminary study.
abstract: OBJECTIVE
  To investigate the potential of virtual non-contrast CT (VNCT) from dual-energy CT to replace true nonenhanced CT (TNCT) for the detection of enlarged cervical lymph nodes.
  
  
  METHODS
  Thirty-nine patients with 94 histopathologically proven cervical lymph nodes were imaged with the dual-energy CT technique. VNCT images from the arterial [VNCT-A] and venous phases [VNCT-V] were obtained with the liver VNC application. The mean CT number and signal-to-noise ratio (SNR) were compared. Image quality was evaluated with a score scale of 1-5. Effective dose (ED) was calculated and compared.
  
  
  RESULTS
  Mean CT numbers of cervical lymph nodes were higher on VNCT than on TNCT (P = 0.034). There was no difference in the SNR among three sets of non-enhanced CT images, but the CNR of VNCT images was higher than that of TNCT images (P < 0.001). Image quality of VNCT from two phases was comparable to that of TNCT (P = 0.070). There was no difference in image quality of three sets of non-enhanced CT images (P > 0.05). ED from dual-phase dual-energy CT was lower than that from tri-phase CT scans (P < 0.001).
  
  
  CONCLUSIONS
  VNCT images from dual-energy CT of the neck had diagnostic image quality; they have the potential to replace TNCT, thus reducing the radiation dose.
authors.affiliation: Department of Medical Imaging, The First Affiliated Hospital of Kunming Medical University, Kunming, 650032, Yunnan, China, yayingyang@163.com.
authors.forename: Yaying
authors.initials: Y
authors.lastname: Yang
authors.forename: Xiaoxia
authors.initials: X
authors.lastname: Jia
authors.forename: Yamin
authors.initials: Y
authors.lastname: Deng
authors.forename: Jiuhong
authors.initials: J
authors.lastname: Chen
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
mesh_terms: D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009333:Neck; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014584:User-Computer Interface
references.citation: Int J Radiat Oncol Biol Phys. 2008 Jun 1;71(2):362-70
references.pmid: 18164833
references.citation: Invest Radiol. 2013 Jan;48(1):1-9
references.pmid: 23070097
references.citation: Radiology. 2009 Aug;252(2):433-40
references.pmid: 19487466
references.citation: Acad Radiol. 2013 May;20(5):596-603
references.pmid: 23490736
references.citation: AJR Am J Roentgenol. 2012 Nov;199(5 Suppl):S40-53
references.pmid: 23097167
references.citation: Clin Radiol. 2013 Feb;68(2):139-47
references.pmid: 22999524
references.citation: Invest Radiol. 2009 Jan;44(1):1-6
references.pmid: 19060790
references.citation: Radiology. 2012 Jul;264(1):119-25
references.pmid: 22570506
references.citation: Clin Radiol. 2012 May;67(5):461-7
references.pmid: 22176725
references.citation: Br J Radiol. 2012 Oct;85(1018):e891-8
references.pmid: 22972978
references.citation: Clin Radiol. 2013 Mar;68(3):264-71
references.pmid: 22974566
references.citation: Radiology. 2010 Jul;256(1):184-90
references.pmid: 20574095
references.citation: AJNR Am J Neuroradiol. 2011 Dec;32(11):1994-9
references.pmid: 21903909
references.citation: Invest Radiol. 2012 May;47(5):306-11
references.pmid: 21577123
references.citation: Cancer Imaging. 2013 Mar 06;13:81-91
references.pmid: 23470989
references.citation: Radiology. 2008 Nov;249(2):671-81
references.pmid: 18796658
references.citation: Eur J Radiol. 2012 Jul;81(7):1438-45
references.pmid: 21501940
references.citation: AJR Am J Roentgenol. 2012 Nov;199(5 Suppl):S64-70
references.pmid: 23097169
references.citation: Radiol Clin North Am. 2009 Jan;47(1):27-40
references.pmid: 19195532
references.citation: Eur J Radiol. 2012 Mar;81(3):e398-405
references.pmid: 22236702
references.citation: AJR Am J Roentgenol. 2012 Nov;199(5 Suppl):S34-9
references.pmid: 23097166
references.citation: Eur Radiol. 2010 Sep;20(9):2257-64
references.pmid: 20393717
references.citation: Eur J Radiol. 2008 Jun;66(3):493-500
references.pmid: 18337039
references.citation: Cancer Imaging. 2008 Sep 30;8:173-80
references.pmid: 18824423