Application of dual-source computed tomography in the diagnosis of thyroid cancer and evaluation of biological behaviors

Objective: Thyroid cancer (TC) is an extremely prevailing malignant endocrine tumor. Therefore, effective diagnostic tools are necessary. This study explored the applica-tion value of dual-source computed tomography (DSCT) in TC diagnosis and biologi-cal behavior assessment.Methods: This study retrospectively selected 68 TC patients and another 74 benign patients with thyroid adenoma, nodular goiter, or adenomatous hyperplasia. All patients were confirmed by pathological examination and underwent DSCT examination. The iodine concentration (IC) obtained from plain computed tomography (CT) scanning and normalized iodine concentration (NIC) in the arterial phase and venous phase were recorded. The positive expression rates of estrogen receptor alpha (ER alpha), estrogen receptors beta (ER beta), and Ki67 in pathological tissues were determined by immunohistochemistry, and their correlation with IC in plain CT was assessed by Pearson correlation analysis, respectively. The diagnostic values of IC in plain CT and venous phase NIC in TC patients were evaluated using the receiver operating characteristic curve.Results: Malignant patients had lower IC in plain DSCT scanning, venous phase NIC, and ER beta, and higher ER alpha and Ki67 than benign patients. IC level in plain DSCT scanning was inversely-correlated with ER alpha and Ki-67 positive expression rates, but positively-related to ER beta to different degrees. For the diagnosis of TC patients, the AUC of IC level in plain DSCT was 0.771, with a cut-off value of 1.250 (97.06% sensitivity and 41.89% specificity), and the AUC of venous phase NIC was 0.738, with a cut-off value of 0.825 (100% sensitivity and 43.24% specificity).Conclusion: The IC level obtained from DSCT scanning could assist in the differential diagnosis of malignant and benign thyroid nodules and evaluation of biological behaviors.