Lower energy levels and iodine-based material decomposition images increase pancreatic ductal adenocarcinoma conspicuity on rapid kV-switching dual-energy CT.

Abstract

PURPOSE:

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.

METHODS:

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.

RESULTS:

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).

CONCLUSION:

The use of low energy levels on rsDECT and iodine maps improves tumor conspicuity. This situation may be help better detection of pancreatic tumors.

• Authors: Serdar Aslan, Ilkay Camlidag, Mehmet Selim Nural
• Journal: Abdominal radiology (New York) (Abdom Radiol (NY)) Vol. 44 Issue 2 Pg. 568-575 (02 2019) ISSN: 2366-0058 [Electronic] United States
• PMID: 30155698 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Iodine

Topics

• Adenocarcinoma (diagnostic imaging)
• Aged
• Aged, 80 and over
• Carcinoma, Pancreatic Ductal (diagnostic imaging)
• Contrast Media
• Female
• Humans
• Iodine
• Male
• Middle Aged
• Multidetector Computed Tomography (methods)
• Pancreatic Neoplasms (diagnostic imaging)
• Prospective Studies
• Radiographic Image Enhancement (methods)
• Radiography, Dual-Energy Scanned Projection