title: Differentiation of lung cancers from inflammatory masses with dual-energy spectral CT imaging.
abstract: OBJECTIVE
  To investigate the value of dual-energy spectral computed tomography (DESCT) in the quantitative differentiation between pulmonary malignant masses and inflammatory masses.
  
  
  METHODS
  This study was an institutional review board-approved study, and written informed consent was obtained from all patients. Sixty patients with 35 lung cancers and 25 inflammatory masses underwent DESCT scan during arterial phase (AP) and venous phase (VP). CT numbers of net enhancement in 70 keV monochromatic images in central and peripheral regions of masses and their differences (dCT) were measured. Iodine concentrations in the two regions were measured and normalized to the aorta as normalized iodine concentrations (NICs). The slopes of spectral attenuation curves (λHU) in the two regions were also calculated. The two-sample t test was used to compare quantitative parameters. Receiver operating characteristic (ROC) curves were generated to calculate sensitivity and specificity.
  
  
  RESULTS
  CT numbers of net enhancement and NICs in central regions, and λHU values both in the central and peripheral region of lung cancers were significantly lower than those of inflammatory masses during AP and VP. On the other hand, the dCT values of lung cancers were higher than that of inflammatory masses. NIC value in the central regions in VP had the highest sensitivity (86%) and specificity (100%) in differentiating malignant masses from inflammatory masses.
  
  
  CONCLUSIONS
  DESCT imaging with quantitative parameters such as CT numbers of 70 keV monochromatic images, NIC, and λHU may be a new method for differentiating lung cancers from inflammatory masses.
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China.
authors.forename: Wei Shu
authors.initials: WS
authors.lastname: Hou
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China. Electronic address: huaweiwu26@163.com.
authors.forename: Hua Wei
authors.initials: HW
authors.lastname: Wu
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China.
authors.forename: Jie Jun
authors.initials: JJ
authors.lastname: Cheng
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd., Pudong, Shanghai 200127, PR China. Electronic address: biyuntian33@sina.com.
authors.forename: Jian Rong
authors.initials: JR
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging; D007479:Iopamidol; D008168:Lung / Q000000981:diagnostic imaging; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008175:Lung Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007479:Iopamidol
keywords: Lung neoplasms; dual-energy CT; granuloma; plasma cell