title: Differentiating malignant vertebral tumours from non-malignancies with CT spectral imaging: a preliminary study.
abstract: OBJECTIVE
  To investigate the value of dual-energy spectral computed tomography (DESCT) for differentiating malignant vertebral tumours from non-malignancies during venous phase.
  
  
  METHODS
  This study was institutional review board-approved, and written informed consent was obtained from all patients. Thirty-seven patients were examined by DESCT during venous phase. Twenty patients had malignant vertebral tumours, 17 had non-malignant vertebral tumours. The iodine/water densities for the lesion, the lesion-to-muscle ratio, and lesion-to-artery ratio for iodine density measurements were calculated and compared between the two groups with the two-tailed Student t test. A p-value < 0.05 was considered statistically significant. Sensitivity and specificity were compared between the qualitative and quantitative studies.
  
  
  RESULTS
  The iodine density, lesion-to-muscle ratio, and lesion-to-artery ratio of the iodine density measurement for malignant vertebral tumours were significantly different from the respective values for non-malignancies (all p < 0.05). Using 0.52 as the threshold value for the lesion-to-artery iodine density ratio, one could obtain sensitivity of 85% and specificity of 100% for differentiating malignant vertebral tumours from non-malignancies, significantly higher than the qualitative diagnosis.
  
  
  CONCLUSIONS
  DESCT imaging enables analysis of a number of additional quantitative CT parameters to improve the accuracy for differentiating malignant vertebral tumours from non-malignancies during venous phase.
  
  
  CONCLUSIONS
  • Dual-energy CT provides a new quantitative method. • CT spectral imaging improves the accuracy of differential diagnosis. • Lesion-to-artery iodine density ratio for malignant vertebral tumours was higher than for non-malignancies.
authors.affiliation: Peking University Third Hospital, No.49 North Garden Street, Haidian District, Beijing, 100191, China, pkuyuan1989@126.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yuan
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Ning
authors.initials: N
authors.lastname: Lang
authors.forename: Jianying
authors.initials: J
authors.lastname: Li
authors.forename: Huishu
authors.initials: H
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007455:Iodine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007455:Iodine