Objective:

To analyze the diagnostic efficiency of IQon energy-spectral CT for quantitative multipa

rametric assessment of lymph node metastasis in lung cancer.

Methods:

A total of 86 patients treated in The Second Peoples Hospital of Hefei from January to June 2021 and pathologically confirmed as non-small cell lung cancer were selected as the research objects. All of patients underwent IQon-spectral CT arterial and venous phase enhanced scans

and lung cancer resection and mediastinal lymph node dissection were performed. A total of 143 lymph nodes were obtained

of which 93 were metastasized and 50 were not. The energy spectrum parameters of primary lung cancer and metastasis

non-metastasis lymph node in arterial and venous phase were compared

and receiver operating characteristic (ROC) curves were used to analyze the clinical value of the energy spectrum parameters in diagnosis of lung cancer lymph node metastasis.

Results:

There was no significant difference in energy spectrum parameters between metastatic lymph nodes and primary lung cancer lesions in the arterial and venous phases (

P

＞0.05). There was a statistically significant difference in the iodine concentration (IC) value

normalized iodine concentration (NIC) value

the slope of the spectral Hounsfeld unit curve (

H

) and effective atomic number (Eff-Z) parameters between the non-metastatic lymph nodes and the primary lung cancer lesions in the arterial and venous phases (

P

＜0.05). There was a statistically significant difference in the lymph node IC value

NIC value

H

and Eff-Z parameters between the metastatic group and the non-metastatic group in the arterialand venous phase (

P

＜0.05). Area under curve (AUC) of the NIC value in the arterial phase group was 0.823

and the sensitivity and specificity for diagnosing lymph node metastasis were 65.48% and 92.72%

respectively; the AUC of the NIC value in venous phase was 0.882

the sensitivity and specificity for diagnosing lymph node metastasis were 84.72% and 82.87%

respectively. The venous phase NIC value has the

highest clinical value in the diagnosis of lung cancer lymph node metastasis.

Conclusion:

IQon-spectral CT multi-parameter quantification has certain clinical application value in the evaluation of lung cancer lymph node metastasis. Among them

the NIC value has the highest diagnostic efficiency

which can provide an important basis for the preoperative lymph node differential diagnosis and designing treatment plan of lung cancer patients.