Detectability of Head and Neck Cancer via New Computed Tomography Reconstruction Tools including Iterative Reconstruction and Metal Artifact Reduction.

ABSTRACT

State-of-the-art technology in Computed Tomography (CT) includes iterative reconstruction algorithms (IR) and metal artefact reduction (MAR) techniques. The objective of the study is to show the benefits of this technology for the detection of primary and recurrent head and neck cancer. A total of 131 patients underwent contrast-enhanced CT for diagnosis of primary and recurrent Head and Neck cancer; 110 patients were included. All scans were reconstructed using iterative reconstruction, and metal artifact reduction was applied when indicated. Tumor detectability was evaluated dichotomously. Histopathological findings were used as a standard of reference. Data were analyzed retrospectively, statistics was performed through diagnostic test characteristics. State-of-the-art Head and Neck CT showed a sensitivity of 0.83 (95% CI; 0.61-0.95) with 0.93 specificity (95% CI; 0.84-0.98) for primary tumor detection. Recurrent tumors were identified with a 0.94 sensitivity (95% CI; 0.71-0.99) and 0.93 specificity (95% CI; 0.84-0.98) in this study. Conclusion: State-of-the-art reconstruction tools improve the diagnostic quality of Head and Neck CT, especially for recurrent tumor detection, compared with data published for standard CT. IR and MAR are easily implemented in routine clinical settings and improve image evaluation by reducing artifacts and image noise while lowering radiation exposure.