CT features and histogram analysis of non-contrast images for differentiating malignant and benign mediastinal lymph nodes in Non-Small Cell Lung Cancer (NSCLC)

by Pakorn Prakaikietikul, Yutthaphan Wannasopha, Juntima Euathrongchit, Apichat Tantraworasin

To evaluate the diagnostic value of CT features and histogram analysis in distinguishing between malignant and benign mediastinal lymph nodes in patients with non-small cell lung cancer (NSCLC).

This retrospective study analyzed non-contrast chest CT images from 40 NSCLC patients, comprising 80 pathology-proven mediastinal lymph nodes (46 benign, 34 metastasis). Morphologic features, including size, shape, margins, and internal composition, were independently assessed by two radiologists. Histogram analysis was conducted using the Synapse Vincent system with six parameters: mean attenuation, mean positive pixel (MPP), standard deviation (SD), skewness, kurtosis, and entropy. Statistical analysis included the Mann-Whitney test for continuous data, Fisher’s exact test for categorical data, and receiver-operating characteristic (ROC) curve analysis to assess diagnostic accuracy, with statistical significance set at p Results

Malignant lymph nodes demonstrated significantly larger sizes (p Conclusion

The combination of morphologic CT features and CT histogram analysis offers a robust method for differentiating malignant from benign mediastinal lymph nodes in NSCLC patients, potentially enhancing diagnostic accuracy and informing treatment strategies.