The relationship between the diagnostic performance of dual-energy CT quantitative parameters in thyroid cancer, cervical lymph node metastasis and prognosis

OBJECTIVE: This study aims to investigate the relationship between quantitative parameters of dual-energy computed tomography (DECT) and its diagnostic performance in thyroid cancer, cervical lymph node metastasis, and prognosis. The objective is to provide more precise information for the early diagnosis and treatment of clinical thyroid cancer. METHODS: We collected clinical data from 80 patients with thyroid cancer, including 40 in the stage IV thyroid cancer group and 40 in the stage III thyroid cancer group, used dual-energy CT technology to scan their neck areas, and obtained relevant quantitative parameters, including enhanced CT values, iodine load, lipid load, etc. We then compared these parameters with clinicopathological data and analyzed their application value in thyroid cancer diagnosis, cervical lymph node metastasis, and prognostic assessment. RESULTS: The average CT enhancement value and iodine load in the stage IV thyroid cancer group were significantly higher than those in the stage III thyroid cancer group (185.4 ± 20.1 HU vs. 155.7 ± 10.5 HU, p < 0.001;) 6.8 ± 1.2 mg/cm³vs. 3.2 ± 0.8 mg/cm³, p < 0.001. The Kaplan-Meier survival curve showed that individuals with CT enhancement values exceeding a specific threshold (145Hu) exhibited longer disease-free survival (DFS) and overall survival (OS). The Cox proportional hazards model indicated that CT enhancement values and iodine load were negatively correlated with DFS and OS. The results of multivariate logistic regression analysis showed that CT enhancement value, gender, lymph node stage and iodine load were the main risk factors affecting DFS and OS (p < 0.05), and CT had an independent impact on thyroid prognosis. GPower analysis showed that the sample size of this study is reasonable. The linearly weighted Kappa value was 0.963, and the consistency of diagnoses among different doctors was good (p < 0.05). CONCLUSION: Dual-energy CT quantitative parameters hold significant clinical value in the early diagnosis of thyroid cancer, the detection of cervical lymph node metastasis, and prognosis assessment. This study offers clinicians a comprehensive evaluation method that is anticipated to enhance treatment strategies and improve prognostic predictions for patients with thyroid cancer. CLINICAL TRIAL NUMBER: Not applicable.