Four-Dimensional Dual-Energy Computed Tomography-Derived Parameters and Their Correlation with Thyroid Gland Functional Status

PURPOSE: Dual-energy computed tomography (DECT) allows for the measurement of iodine concentration, a component for the synthesis of thyroid hormones. DECT can create virtual non-contrast (VNC) images, potentially reducing radiation exposure. This study explores the correlations between thyroid function and iodine concentration, as well as the relationship between thyroid densities in true non-contrast (TNC) and virtual non-contrast (VNC) images and thyroid function. METHODS: The study involved 87 patients undergoing 4D-CT imaging with single and dual-energy scans for diagnosing primary hyperparathyroidism. Thyroid densities and iodine concentrations were measured across all scanning phases. These measurements were correlated with thyroid function, indicated by TSH and FT4 levels. Differences in thyroid density between post-contrast phases and TNC phases (?HU) were analyzed for correlations with thyroid function and iodine concentrations. RESULTS: Positive correlations between iodine concentrations and TSH were found, with Spearman's coefficients (R) of 0.414, 0.361, and 0.349 for non-contrast, arterial, and venous phases, respectively. Thyroid density on TNC showed significant positive correlations with TSH levels (R = 0.436), consistently across both single- (R = 0.435) and dual-energy (R = 0.422) scans. Thyroid densities on VNC images did not correlate with TSH or FT4. Differences in density between contrast and non-contrast scans (?HU) negatively correlated with TSH ( = 0.002). CONCLUSIONS: DECT-derived iodine concentrations and thyroid densities in non-contrast CT scans demonstrated positive correlations with thyroid function, in contrast to thyroid densities on VNC scans. This indicates that VNC images are unsuitable for this purpose. Correlations between ?HU and TSH suggest a potential link between the thyroid's structural properties to capture iodine and its hormonal function. This study underscores the potential value of (DE-) CT imaging for evaluating thyroid function as an additional benefit in head and neck scans.