Dual energy computed tomography for detection of metastatic lymph nodes in patients with hepatocellular carcinoma

Table 1 Quantitative parameters [median (P25, P75)] for metastatic vs non-metastatic lymph nodes in patients with hepatocellular carcinoma

Parameter		Metastatic (group P)	Non-metastatic (group N)	P-value
Maximal short axis diameter (cm)		1.25 (0.90, 1.80)	0.60 (0.50, 0.80)	< 0.001
IC (mg/mL)	AP	10.46 (9.41, 11.36)	8.64 (7.62, 9.82)	< 0.001
	PP	22.70 (19.08, 26.35)	13.26 (9.91, 16.26)	< 0.001
	DP	19.03 (16.18, 21.34)	14.09 (12.14, 15.71)	< 0.001
NIC	AP	0.12 (0.10, 0.13)	0.08 (0.06, 0.11)	< 0.001
	PP	0.54 (0.37, 0.82)	0.10 (0.07, 0.18)	< 0.001
	DP	0.57 (0.49, 0.77)	0.34 (0.23, 0.44)	< 0.001
λHU	AP	0.64 (0.57, 0.73)	0.49 (0.41, 0.58)	< 0.001
	PP	1.53 (1.26, 1.90)	0.87 (0.60, 0.94)	< 0.001
	DP	1.30 (1.15, 1.74)	0.85 (0.71, 1.40)	< 0.001

IC: Iodine concentration; NIC: Normalized iodine concentration; λ_HU: Slope of the spectral curve; AP: Arterial phase; PP: Portal phase; DP: Delayed phase.

Table 2 Quantitative parameters [median (P25, P75)] for lymph nodes in patients with hepatocellular carcinoma complicated with active vs non-active hepatitis

		Metastatic		P-value	Non-metastatic		P-value
		Active hepatitis (group P1)	Non-active hepatitis (group P2)		Active hepatitis (group N1)	Non-active hepatitis (group N2)
Maximal short axis diameter (cm)		1.50 (1.12, 2.00)	1.40 (0.90, 1.70)	0.058	0.70 (0.58, 0.90)	0.60 (0.50, 0.78)	0.083
IC (mg/mL)	AP	10.12 (7.63, 12.87)	11.02 (8.40, 13.68)	0.899	9.07 (6.35, 11.53)	7.73 (5.46, 9.58)	0.099
	PP	20.75 (18.40, 24.28)	18.83 (14.95, 21.31)	0.647	15.03(10.21, 18.02)	13.82 (10.40, 19.05)	0.001
	DP	14.19 (11.59, 17.47)	13.49 (10.53, 18.77)	0.793	19.65 (14.47, 22.62)	18.03 (13.78, 21.13)	0.908
NIC	AP	0.12 (0.08, 0.15)	0.11 (0.08, 0.14)	0.269	0.10 (0.07, 0.12)	0.10 (0.07, 0.13)	0.598
	PP	0.39 (0.27, 0.51)	0.34 (0.26, 0.43)	0.165	0.31 (0.23, 0.39)	0.19 (0.16, 0.26)	0.013
	DP	0.55 (0.42, 0.68)	0.51 (0.43, 0.65)	0.785	0.40 (0.35, 0.56)	0.35 (0.25, 0.44)	0.647
λHU	AP	0.62 (0.48, 0.82)	0.70 (0.53, 0.84)	0.195	0.49 (0.35, 0.64)	0.57 (0.40, 0.73)	0.161
	PP	1.45 (1.15, 1.67)	1.38 (0.89, 1.43)	0.73	0.95 (0.65, 1.16)	0.80 (0.68, 1.19)	0.002
	DP	1.23 (0.90, 1.44)	1.17 (1.01, 1.33)	0.812	0.91 (0.75, 1.11)	0.87 (0.66, 1.12)	0.726

IC: Iodine concentration; NIC: Normalized iodine concentration; λ_HU: Slope of the spectral curve; AP: Arterial phase; PP: Portal phase; DP: Delayed phase.

Table 3 Cut-off values, area under the curve, sensitivity, and specificity of dual-energy computed tomography for metastatic vs non-metastatic lymph nodes in patients with hepatocellular carcinoma

Parameter		AUC	Cut-off value	Sensitivity, %	Specificity, %
Maximal short axis diameter(cm)		0.883	0.950	73.3	88.7
IC (mg/mL)	AP	0.697	9.845	68.6	72.0
	PP	0.902	18.060	81.9	82.4
	DP	0.755	16.005	73.6	76.9
NIC	AP	0.756	0.106	72.8	73.9
	PP	0.918	0.272	83.9	84.1
	DP	0.836	0.467	74.5	79.2
λHU	AP	0.755	0.582	73.8	75.6
	PP	0.889	1.098	81.8	84.1
	DP	0.836	1.077	78.1	79.0
Diameter + λHU (PP)		0.945	Combined diagnosis in parallel	86.2	89.8
Diameter + IC (PP)		0.884		84.5	83.0
Diameter + NIC (PP)		0.960		86.9	93.6

IC: Iodine concentration; NIC: Normalized iodine concentration; λ_HU: Slope of the spectral curve; AP: Arterial phase; PP: Portal phase; DP: Delayed phase.