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The radiomics signature was selected based on reproducible features by using the least absolute shrinkage and selection operator method, and highly related radiomic, clinical features and DECT findings were selected to establish the radiomics-clinical model by using multivariable logistic regression analysis. Nomogram performance was evaluated by its discrimination, calibration, and clinical use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with the single-parametric DECT radiomic models, the multi-parametric model can improve the diagnostic efficacy for differentiating laryngeal benign from malignant lesions, with area under the curves (AUCs) of 0.938 in training set and 0.920 in test set, respectively. Moreover, multi-parametric DECT-based radiomics-clinical model incorporates the radiomics signature and DECT-reported lesion size showed the best diagnostic performance (AUC of 0.945) in the whole cohort, when compared with the radiomics model (AUC of 0.933, P\u00a0&amp;lt;.05) and clinical model (AUC of 0.855, P\u00a0&amp;lt;.05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The multi-parametric DECT-based radiomics-clinical model can serve as an important modality for non-invasively differentiating laryngeal benign lesions from malignant ones.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This study highlights the value of DECT-based radiomics model for differentiating laryngeal benign from malignant lesions. Moreover, the combination of radiomic, clinical features and DECT findings demonstrated good performance for differential diagnosing in laryngeal lesions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjr\/tqaf311","type":"journal-article","created":{"date-parts":[[2025,12,18]],"date-time":"2025-12-18T04:19:54Z","timestamp":1766031594000},"page":"525-534","source":"Crossref","is-referenced-by-count":0,"title":["Multi-parametric dual-energy CT radiomics for differentiating laryngeal benign and malignant lesions"],"prefix":"10.1093","volume":"99","author":[{"given":"Yang","family":"Zhan","sequence":"first","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]},{"name":"Department of Radiology, Zhongshan Hospital, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengxiu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Magnetic Resonance, East China Normal University , Shanghai 200062,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuzhe","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]},{"name":"Department of Radiology, Zhongshan Hospital, Fudan University , Shanghai 200032,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3057-0691","authenticated-orcid":false,"given":"Peng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]},{"name":"Department of Radiology, Affiliated Hospital of Jiangnan University , Wuxi 214122,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fei","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingfeng","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang","family":"Yang","sequence":"additional","affiliation":[{"name":"Shanghai Key Laboratory of Magnetic Resonance, East China Normal University , Shanghai 200062,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4687-5905","authenticated-orcid":false,"given":"Zuohua","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University , Shanghai 200031,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,17]]},"reference":[{"key":"2026032003514065600_tqaf311-B1","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s11864-021-00881-w","article-title":"Management of laryngeal dysplasia and early invasive cancer","volume":"22","author":"Hrelec","year":"2021","journal-title":"Curr Treat Options Oncol"},{"key":"2026032003514065600_tqaf311-B2","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1016\/j.critrevonc.2016.07.004","article-title":"Laryngeal preneoplastic lesions and cancer: challenging diagnosis. 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