Analysis of risk factors for thyroid cartilage invasion in laryngeal carcinoma and the value of tumor volume based on DECT derived iodine overlay image in diagnosing thyroid cartilage invasion / 中国介入影像与治疗学

ABSTRACT

Objective: To investigate the risk factors associated with thyroid cartilage invasion in laryngeal carcinoma, and to analyze the efficacy of tumor volume based on dual-energy CT (DECT) derived iodine overlay image for diagnosing thyroid cartilage invasion. Methods: Totally 108 patients with laryngeal squamous cell carcinoma confirmed by pathology were retrospectively analyzed. The patients were divided into thyroid cartilage invasion group (n=49) and non-invasion group (n=59). The clinic data and the tumor volume based on DECT derived iodine overlay image were compared. The risk factors related to thyroid cartilage invasion in laryngeal carcinoma were analyzed using binary Logistic regression, and the efficacy of each risk factor in diagnosing thyroid cartilage invasion was further analyzed. Results: No significant difference in gender, age, disease duration and tumor differentiation between thyroid cartilage invasion group and non-invasion group (all P>0.05), while the clinical type of tumor, anterior commissure involvement and tumor volume were significantly different between the two groups (all P<0.01). The Logistic regression analysis showed that tumor volume based on iodine overlay image (P<0.01) and anterior commissure involvement (P=0.03) were risk factors of thyroid cartilage invasion. Taking the tumor volume=3.91 cm3 as the cutoff value, the sensitivity and specificity for the diagnosis of thyroid cartilage invasion were 93.90% and 89.80%, with the Youden index of 0.84 and AUC of 0.97 (95%CI [0.94, 0.99], P<0.01), respectively. Conclusion: Tumor volume based on DECT derived iodine map and anterior commissure invasion are risk factors for thyroid cartilage invasion in laryngeal carcinoma. Tumor volume based on DECT derived iodine map can be used to diagnose thyroid cartilage invasion.