Objective and subjective image quality of primary and recurrent squamous cell carcinoma on head and neck low-tube-voltage 80-kVp computed tomography

Publication

Objective and subjective image quality of primary and recurrent squamous cell carcinoma on head and neck low-tube-voltage 80-kVp computed tomography

Journal Paper/Review - Mar 26, 2015

Scholtz Jan-Erik, Vogl Thomas J, Lehnert Thomas, Bauer Ralf, Kerl J Matthias, Wagenblast Jens, Burck Iris, Schulz Boris, Scheerer Friedrich, Nöske Eva-Maria, Kraft Johannes, Kaup Moritz, Wichmann Julian L

Citation

Scholtz J, Vogl T, Lehnert T, Bauer R, Kerl J, Wagenblast J, Burck I, Schulz B, Scheerer F, Nöske E, Kraft J, Kaup M, Wichmann J. Objective and subjective image quality of primary and recurrent squamous cell carcinoma on head and neck low-tube-voltage 80-kVp computed tomography. Neuroradiology 2015; 57:645-51.

Type

Journal Paper/Review (English)

Journal

Neuroradiology 2015; 57

Publication Date

Mar 26, 2015

Issn Electronic

1432-1920

Pages

645-51

Brief description/objective

INTRODUCTION
To investigate low-tube-voltage 80-kVp computed tomography (CT) of head and neck primary and recurrent squamous cell carcinoma (SCC) regarding objective and subjective image quality.

METHODS
We retrospectively evaluated 65 patients (47 male, 18 female; mean age: 62.1 years) who underwent head and neck dual-energy CT (DECT) due to biopsy-proven primary (n = 50) or recurrent (n = 15) SCC. Eighty peak kilovoltage and standard blended 120-kVp images were compared. Attenuation and noise of malignancy and various soft tissue structures were measured. Tumor signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated. Subjective image quality was rated by three reviewers using 5-point grading scales regarding overall image quality, lesion delineation, image sharpness, and image noise. Radiation dose was assessed as CT dose index volume (CTDIvol). Interobserver agreement was calculated using intraclass correlation coefficient (ICC).

RESULTS
Mean tumor attenuation (153.8 Hounsfield unit (HU) vs. 97.1 HU), SNR (10.7 vs. 8.3), CNR (8.1 vs. 4.8), and subjective tumor delineation (score, 4.46 vs. 4.13) were significantly increased (all P < 0.001) with 80-kVp acquisition compared to standard blended 120-kVp images. Noise of all measured structures was increased in 80-kVp acquisition (P < 0.001). Overall interobserver agreement was good (ICC, 0.86; 95 % confidence intervals: 0.82-0.89). CTDIvol was reduced by 48.7 % with 80-kVp acquisition compared to standard DECT (4.85 ± 0.51 vs. 9.94 ± 0.81 mGy cm, P < 0.001).

CONCLUSIONS
Head and neck CT with low-tube-voltage 80-kVp acquisition provides increased tumor delineation, SNR, and CNR for CT imaging of primary and recurrent SCC compared to standard 120-kVp acquisition with an accompanying significant reduction of radiation exposure.