Value of multiple quantitative dual-energy CT parameters combined with conventional CT signs to identify benign and malignant primary epithelial tumors of the ovary
CHEN Suyue
CHEN Wang
GUO Rong
ZHAO Yi
Abstract：Objective To explore the clinical application value of multiple quantitative dual-energy CT parameters combined with conventional CT signs to identify benign and malignant primary epithelial tumors of the ovary.Methods A retrospective study was conducted in 166 cases with primary epithelial tumors of the ovary confirmed by pathology findings from January 2021 to June 2023 continuously at the First People's Hospital of Yancheng City.All patients underwent contrast-enhanced dual-energy CT scans within 2 weeks prior to surgery.Patients were devided into benign group(n=74)and malignant group(n=92)according to pathology.Common clinical characteristics and conventional CT signs were recorded.Two independent observers measured the lesion-related quantitative dual-energy CT parameters:iodine concentrations of arterial and venous phases,standardized iodine concentrations,and monoenergetic CT values at 40,50,60,70,80,90 keV levels.The slope of energy spectrum curve(K40-90keV)during both arterial and venous phase were calculated.Intra-group correlation coefficient was used to evaluate the consistency of the parameters obtained by the 2 observers.Differences in parameters between the two groups were compared.Variables with a P-value less than 0.1 were selected as input variables for constructing stepwise binary logistic regression models based on conventional CT signs,quantitative dual-energy CT parameters and the combination of both.The efficacy of the three models in the differential diagnosis of benign and malignant ovarian tumors were evaluated with ROC curve.The areas under these curves were compared using the DeLong test.Results Parameters of the arterial and venous phase obtained by the two observers showed consistency in the two groups.The intra-group correlation coefficients were all above 0.75.Significant differences were found in general clinical characteristics(age,clinical symptoms),eight conventional CT signs(tumor location,morphology,boundary,density,ascites,metastases to peritoneum/omentum,supradiaphragmatic lymph nodes,and other organs or not),and various quantitative dual-energy CT parameters(CT40keV,CT50keV,CT60keV,CT70keV,CT80keV,CT90keV,K40-90keV,iodine concentration and standardized iodine concentration)in benign and malignant groups(P<0.05).The area under ROC curve of binary logistic regression model based on conventional CT signs,quantitative dual-energy CT parameters and their combination were 0.760,0.764,0.883 respectively.According to the DeLong test,no significant difference was found in the area under the curve between the model based on conventional CT signs and the quantitative dual-energy CT parameters model(Z=-0.659,P=0.510).Significant differences were observed between the models based on conventional CT signs and the combined model(Z=-4.007,P<0.001),and between the quantitative dual-energy CT parameters model and the combined model(Z=-3.870,P=0.001).Conclusion Compared with conventional CT signs or multiple quantitative dual-energy CT parameters,the combination of them has better diagnostic performance in differentiating benign from malignant primary epithelial tumors of the ovary.
Keywords：primary epithelial tumor of the ovarydual-energy CTmultiple quantitative parameters
Publication Date：2023-12-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 1035-1042 )