Article Figures & Data
Figures
- FIG 1.
Conventional (A), iodine density (B), and Z-effective (C) images illustrating an ROI placed over a right tongue base squamous cell carcinoma. ROI size is 4.89 mm in diameter (ED), with an average area (Av) of 18.76 mm2. ROI measurements were obtained over 3 image slices (not shown), with the average iodine and Z-effective values calculated. A right level IIa cystic nodal metastasis is also present (not labeled).
- FIG 2.
Head and neck squamous cell carcinomas demonstrate a higher mean iodine density = 2.01 (SD 0.26) mg/mL (95% CI, 1.70−2.51 mg/mL) and mean Z-effective value = 8.21 (SD, 0.360) (95% CI, 8.05–8.91) compared with normal tissue (P < .001).
- FIG 3.
ROC plot of the iodine density and Z-effective values for differentiation of upper aerodigestive HNSCC from normal mucosa tissue. The optimal iodine density cutoff is 1.58 (95% CI, 1.45−1.71; P < .001) with a sensitivity of 1 and a specificity of 0.93. The optimal Z-effective cutoff is 8.08 (95% CI, 7.96–8.19; P < .001) with a sensitivity of 0.86 and a specificity of 0.93, respectively.
- FIG 4.
A 61-year-old man with left oral tongue squamous cell carcinoma (arrow) seen on a conventional CT image (A). Iodine density (B), color iodine density overlay (C), and Z-effective (D) images show markedly improved contrast resolution of the tumor from the surrounding normal oral tongue mucosa. The left oral tongue tumor has an iodine density = 2 mg/mL and a Z-effective value = 8.33. Normative oral tongue mucosa values from the healthy control cohort are iodine density = 0.92 mg/mL and Z-effective value = 7.67.
- FIG 5.
A 70-year-old man with left vocal cord squamous cell carcinoma (asterisk) and asymmetric sclerosis of the right arytenoid cartilage (arrowhead) seen on a conventional CT image (A). Iodine density (B), color iodine density overlay (C), and Z-effective (D) images reveal right paraglottic fat involvement with increased iodine density. The patient was upstaged from T2 to T3.
- FIG 6.
A 63-year-old man with left buccal and alveolar mucosa squamous cell carcinoma (arrows) seen on the conventional images in soft-tissue (A) and bone (B) window settings. Iodine density (B), color iodine density overlay (C), and Z-effective (D) images reveal right mandibular bone invasion with increased iodine density in the medullary cavity of the left hemimandible (arrowhead). T1-weighted MR imaging (E) and post-gadolinium-enhanced T1 fat-saturated (F) image confirm bone marrow infiltration. The patient was upstaged from T3 to T4a.
Tables
Summary of iodine density and Z-effective values for normal tissue subsites
Normal Tissue Iodine Density (mg/mL) (Mean) (SD) Z-Effective Value (Mean) (SD) Mucosal subsites Floor of mouth (1.43) (0.26) (7.95) (0.31) Buccal mucosa (0.83) (0.13) (7.41) (0.24) Oral tongue (0.92) (0.17) (7.67) (0.24) Soft palate (1.25) (0.35) (7.96) (0.26) Palatine tonsils (1.32) (0.39) (8.01) (0.26) Tongue base (1.22) (0.48) (7.89) (0.30) Aryepiglottic fold (1.12) (0.38) (7.79) (0.28) Vocal fold (1.13) (0.32) (7.87) (0.29) Post-cricoid hypopharynx (1.02) (0.55) (7.75) (0.39) Cervical esophagus (1.23) (0.60) (7.91) (0.39) All mucosa (1.15) (0.23) (7.82) (0.34) Muscle subsites SCM (0.77) (0.20) (7.84) (0.57) Longus coli (0.89) (0.21) (7.76) (0.16) Genioglossus (0.73) (0.22) (7.67) (0.17) All muscle (0.80) (0.22) (7.76) (0.35) Note:—SCM indicates sternocleidomastoid muscle.
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