The diagnosis value of dual-energy computed tomography (DECT) multi-parameter imaging in lung adenocarcinoma and squamous cell carcinoma

Background: Lung cancer continues to pose a serious risk to human health. With a high mortality rate, non-small cell lung cancer (NSCLC) is the major type of lung cancer, making up to 85% of all cases of lung cancer. Lung adenocarcinoma (AC), and lung squamous cell carcinoma (SC) are the two primary types of NSCLC. Determining the pathological type of NSCLC is important in establishing the most effective treatment method. Dual-energy computed tomography (DECT) multi-parameter imaging is an imaging technology that provides accurate and reliable disease diagnosis, and its uses are utilized for the combined diagnostic efficacy of AC and SC. The purpose of this study was to investigate the diagnostic value of spectral parameters of DECT in efficacy to AC and SC, and their combined diagnostic efficacy was also analyzed.

Methods: We conducted a retrospective analysis of clinical and imaging data for 36 patients diagnosed with SC and 35 patients with AC. These patients underwent preoperative DECT chest scans, encompassing both arterial and venous phases, at our hospital from December 2020 to April 2022. The tumor diameter, water concentration (WC), iodine concentration (IC), normalized iodine concentration (NIC), Z effective (Zeff), and slope of the curve (K) in lesions were evaluated during two scanning phases in the two separate pathological types of lung cancers. The differences in parameters between these two types of lung cancers were statistically analyzed. In addition, receiver operating characteristic (ROC) curves were performed for these parameters to distinguish between SC and AC.

Results: In a univariate analysis involving 71 lung cancer patients, the results from Zeff, IC, NIC, and K from the AC's arterial and venous phase images were more elevated than those from the SC (P < 0.05). In contrast, the WC results were lower than those from SC (P < 0.05). The area under the ROC curve (AUC) for multi-parameter joint prediction typing was 0.831, with a corresponding sensitivity of 63.9% and specificity of 94.3%.

Conclusion: It is possible to distinguish between central SC and AC using the spectrum characteristics of DECT-enhanced scanning (Zeff, IC, NIC, K, WC, and tumor diameter). Diagnostic effectiveness can be greatly improved when multiple variables are included.