Lower energy levels and iodine-based material decomposition images increase pancreatic ductal adenocarcinoma conspicuity on rapid kV-switching dual-energy CT
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Multidetector computed tomography (MDCT) is used in the diagnosis of pancreatic ductal adenocarcinoma (PDAC), but it may be inadequate in some cases. Tumor detection can be improved using rapid kV-switching dual-energy CT (rsDECT) and iodine maps. Our aim this study is to evaluate tumor conspicuity in PDAC cases using rsDECT and iodine maps.
Ninety cases with PDAC were evaluated rsDECT. Tumor contrast (HU) differences, tumor size, CNR (contrast-noise ratio), and noise were measured at 70 keV, individual CNR-energy level, and 45 keV, respectively. Quantitative differences in contrast gain ∆70-CNR and ∆CNR-45 were compared. On iodine maps, the iodine concentration measured in the tumor and parenchyma was normalized to the aorta as normalized iodine concentration (NIC) and compared.
The median optimized viewing energy level was 51 keV. The mean ± SD tumor contrast values were 62 ± 20, 115 ± 48, and 152 ± 48 HU (p < 0.001); the largest axial diameters were 36.6 ± 5.1, 37.9 ± 4.2, and 38.3 ± 3.7 mm (p = 0.015); the CNRs were 1.83 ± 0.72, 3.37 ± 0.93, and 2.36 ± 0.56; and the image noise levels were 23.7 ± 6.8, 39.3 ± 11.6, and 59.5 ± 17.2 (p < 0.001) (p < 0.001) for 70 keV, optimized energy level, and 45 keV, respectively. The mean ± SD contrast gain ∆70-CNR was 63 ± 12; and ∆CNR-45 was 31 ± 26 HU (p < 0.001). NICtumor and NICparenchyma values were 0.62 ± 0.03 and 1.36 ± 0.05 mg/mL, respectively (p = 0.004).
The use of low energy levels on rsDECT and iodine maps improves tumor conspicuity. This situation may be help better detection of pancreatic tumors.
KeywordsPancreatic ductal adenocarcinoma Rapid kV-switching dual-energy computed tomography İodine concentration
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
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