The impact of a supporting device-fixed patient position for CT scanning on the diagnostic performance in thyroid cancer
10.3760/cma.j.cn112149-20241023-00641
- VernacularTitle:辅助装置固定体位CT扫描对甲状腺癌诊断效能的影响
- Author:
Ruigang HUANG
1
;
Huijuan HUANG
;
Dongyi CHEN
;
Zhenghan YANG
;
Pengfei ZHAO
;
Huijun XIAO
;
Furong LUO
;
Weihua LIN
Author Information
1. 福建医科大学附属漳州市医院医学影像科，漳州 363000
- Publication Type:Journal Article
- Keywords:
Thyroid neoplasms;
Tomography, X-ray computed;
Position;
Image quality;
Radiation dose
- From:
Chinese Journal of Radiology
2025;59(5):518-525
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the role of a modified positioning device in improving image quality and diagnostic efficacy for thyroid cancer in contrast-enhanced neck CT imaging.Methods:This prospective cross-sectional study included 137 patients with pathologically confirmed thyroid lesions who underwent contrast-enhanced neck CT at Zhangzhou Affiliated Hospital of Fujian Medical University from January to April 2024. Patients scanned in January and February (modified positioning group, n=62) underwent scanning using the modified positioning device, whereas those scanned in March and April (traditional positioning group, n=75) underwent scanning with conventional positioning. The estimated volume CT dose index (CTDI vol) in the thyroid region was recorded. Subjective image quality for thyroid and neck regions was evaluated using a 5-point Likert scale. Diagnostic assessments for thyroid cancer, capsule invasion, and lymph node metastasis were independently conducted by one junior radiologist and one senior radiologist using a 5-point scoring system, with scores≥3 considered positive diagnoses. The differences of CTDI vol and image quality scores between the 2 groups were compared using Mann-Whitney U test. The diagnostic performance was evaluated by the receiver operating characteristic curve analysis. Results:The estimated CTDI vol values for the thyroid region were significantly lower in the modified positioning group compared to the traditional positioning group [11.20 (8.37, 13.56) vs. 12.46 (10.10, 19.43) mGy, Z=1.99, P=0.026]. Subjective image quality scores for thyroid and neck regions were significantly higher in the modified positioning group than in the traditional positioning group (all P<0.001). For thyroid cancer diagnosis by the senior radiologist, the modified positioning group had a significantly higher area under the curve (AUC) of 0.842 (95% CI 0.728-0.956) compared to the traditional positioning group (AUC=0.666,95% CI 0.554-0.777, Z=2.17, P=0.031). No significant differences were observed in diagnostic performance between the junior and senior radiologists for thyroid cancer, capsule invasion, and lymph node metastasis in other subgroup comparisons (all P>0.05). Conclusion:The modified positioning device using in contrast-enhanced neck CT imaging can improve image quality and diagnostic efficacy for thyroid cancer while reducing radiation exposure to the thyroid gland.
