Diagnostic performance of quantitative parameters derived from twin-beam dual-energy CT for differentiating benign and malignant salivary gland tumors of the palate.
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OBJECTIVES: To evaluate the diagnostic performance of quantitative parameters derived from twin-beam dual-energy computed tomography (TB-DECT) in distinguishing benign from malignant palatal salivary gland tumours. METHODS: This retrospective study included 45 patients with pathologically confirmed palatal salivary gland tumours (23 benign, 22 malignant), all of whom underwent contrast-enhanced TB-DECT. Quantitative and qualitative imaging features were analysed using TB-DECT images. Quantitative parameters included iodine concentration (IC), normalized IC (NIC), effective atomic number (Z), electron density (Rho), dual-energy index (DEI), and the slope of the spectral attenuation curve (λHU). Statistical analyses were performed to identify predictors of malignancy. RESULTS: Tumour size did not differ significantly between groups. However, malignant tumours showed significantly higher Hounsfield units (HU) at 1-minute post-contrast (P = 0.050). Among DECT parameters, IC, NIC, Z, DEI, and λHU were significantly elevated in malignant tumours (P < .05). Univariate logistic regression showed significant associations of malignancy with IC (OR, 1.609; P = .020), DEI_N (OR, 65.605; P = .025), λHU (OR, 3.494; P = .033), and HU at 66 keV (OR, 1.028; P = .009). Multivariate analysis was limited by multicollinearity and small sample size. CONCLUSION: TB-DECT-derived parameters, especially IC, DEI, and λHU, may aid in differentiating malignant from benign palatal salivary gland tumours. Virtual monochromatic images at low keV levels can enhance discrimination between malignant and benign lesions.