CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2024; 34(04): 661-669
DOI: 10.1055/s-0044-1787780
Original Article

Diagnostic Imaging Performance of Dual-Energy Computed Tomography Compared with Conventional Computed Tomography and Magnetic Resonance Imaging for Uterine Cervical Cancer

1   Department of Radiology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
2   Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
2   Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
2   Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
1   Department of Radiology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
1   Department of Radiology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
3   Department of Radiology Technology, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
,
4   Department of Obstetrics and Gynecology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
,
2   Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
› Author Affiliations
Funding The funding for this article was provided by Bayer Academic Support (grant no.: BASJ20220418025).

Abstract

Objective This article evaluates the ability of low-energy (40 keV) virtual monoenergetic images (VMIs) in the local diagnosis of cervical cancer compared with that of conventional computed tomography (C-CT) and magnetic resonance imaging (MRI), using clinicopathologic staging as a reference.

Methods This prospective study included 33 patients with pathologically confirmed cervical cancer who underwent dual-energy CT and MRI between 2021 and 2022. The contrast-to-noise ratio (CNR) of the tumor-to-myometrium was compared between C-CT and VMI. Additionally, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for each local diagnostic parameter were compared between C-CT, VMI, and MRI. Interradiologist agreement was also assessed.

Results The mean CNR was significantly higher on VMI (p = 0.002). No significant difference in AUC was found between C-CT and VMI for all local diagnostic parameters, and the specificity of VMI was often significantly less than that of MRI. For parametrial invasion, mean sensitivity, specificity, and AUC for C-CT, VMI, and MRI were 0.81, 0.99, 0.93; 0.64, 0.35, 0.79; and 0.73, 0.67, 0.86, respectively, and MRI had significantly higher specificity and AUC than that of VMI (p = 0.013 and 0.008, respectively). Interradiologist agreement was higher for VMI than C-CT and for MRI than VMI.

Conclusion The CNR of VMI was significantly higher than C-CT and interradiologist agreement was better than with C-CT; however, the overall diagnostic performance of VMI did not significantly differ from C-CT and was inferior to MRI. VMI was characterized by low specificity, which should be understood and used for reading.

Authors' Contributions

T.S.: Methodology, formal analysis, and investigation.

S.S.: Writing – original draft preparation.

S.S., T.S., K.M., T.I., T.A., M.Y., M.M., T.S., and T.N.: Writing – review and editing.

T.S., K.M., T.I., T.A., M.Y., M.M., and T.S.: Resources.

T.N.: Supervision.




Publication History

Article published online:
12 July 2024

© 2024. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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