AUTHOR=Zhang Guojin , Li Shenglin , Yang Ke , Shang Lan , Zhang Feng , Huang Zixin , Ren Jialiang , Zhang Zhuoli , Zhou Junlin , Pu Hong , Man Qiong , Kong Weifang 

TITLE=The value of dual-energy spectral CT in differentiating solitary pulmonary tuberculosis and solitary lung adenocarcinoma

JOURNAL=Frontiers in Oncology

VOLUME=12

YEAR=2022

URL=https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2022.1000028

DOI=10.3389/fonc.2022.1000028

ISSN=2234-943X

ABSTRACT=<sec><title>Background</title><p>To explore the value of dual-energy spectral CT in distinguishing solitary pulmonary tuberculosis (SP-TB) from solitary lung adenocarcinoma (S-LUAD).</p></sec><sec><title>Methods</title><p>A total of 246 patients confirmed SP-TB (n = 86) or S-LUAD (n = 160) were retrospectively included. Spectral CT parameters include CT<sub>40keV</sub> value, CT<sub>70keV</sub> value, iodine concentration (IC), water concentration (WC), effective atomic number (Zeff), and spectral curve slope (λ<sub>70keV</sub>). Data were measured during the arterial phase (AP) and venous phase (VP). Chi-square test was used to compare categorical variables, Wilcoxon rank-sum test was used to compare continuous variables, and a two-sample <italic>t</italic>-test was used to compare spectral CT parameters. ROC curves were used to calculate diagnostic efficiency.</p></sec><sec><title>Results</title><p>There were significant differences in spectral CT quantitative parameters (including CT<sub>40keV</sub> value [all <italic>P&lt;</italic> 0.001] , CT<sub>70keV</sub> value [all <italic>P&lt;</italic> 0.001], λ<sub>70keV</sub> [<italic>P&lt;</italic> 0.001, and <italic>P</italic> = 0.027], Zeff [<italic>P =</italic>0.015, and <italic>P</italic> = 0.001], and IC [<italic>P =</italic>0.002, and <italic>P</italic> = 0.028]) between the two groups during the AP and VP. However, WC (<italic>P =</italic> 0.930, and <italic>P</italic> = 0.823) was not statistically different between the two groups. The ROC curve analysis showed that the AUC in the AP and VP was 90.9% (95% CI, 0.873-0.945) and 83.4% (95% CI, 0.780-0.887), respectively. The highest diagnostic performance (AUC, 97.6%; 95% CI, 0.961-0.991) was achieved when all spectral CT parameters were combined with clinical variables.</p></sec><sec><title>Conclusion</title><p>Dual-energy spectral CT has a significant value in distinguishing SP-TB from S-LUAD.</p></sec>