Optimal virtual monoenergy for the detection of pancreatic adenocarcinoma during the pancreatic parenchymal phase on photon counting CT.

IF 2.3 3区医学 Q2 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Abdominal Radiology Pub Date : 2025-01-07 DOI:10.1007/s00261-024-04696-9

Andrew Ruff, Xiaochun Li, Judith D Goldberg, Mark Ehrhart, Luke Ginocchio, Paul Smereka, Thomas O'Donnell, Bari Dane

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引用次数: 0

Abstract

Purpose: As the pancreas is a low contrast visibility organ, pancreatic ductal adenocarcinoma detection is challenging due to subtle attenuation differences between tumor and pancreatic parenchyma. Photon counting CT (PCCT) has superior iodine contrast-to-noise ratio than conventional CT and also affords the creation of low keV virtual monoenergetic images, both of which increase adenocarcinoma conspicuity. The purpose therefore was to identify the optimal virtual monoenergy for visualizing PDAC during the pancreatic parenchymal phase of enhancement at PCCT using both quantitative and qualitative analyses.

Methods: Consecutive patients with pancreatic parenchymal phase PCCT source data were retrospectively identified by PACS search. For the quantitative analysis, region of interest (ROI) measurements were drawn in the pancreatic head, body, tail, pancreatic adenocarcinoma (if present), and psoas muscles on 40-120 keV virtual monoenergetic images in 10 keV increments. Based on the quantitative analysis results and vendor recommendations, four virtual monoenergies(40 keV, 55 keV, 70 keV, and 85 keV) were selected for additional qualitative analysis. Three radiologists blinded to four virtual monoenergies assessed overall image quality, image noise, pancreatic enhancement, and pancreatic mass conspicuity on 5-point Likert scales.

Results: 54 patients (28/54 male, mean[SD] age: 62 [13] years) were included. Quantitatively, 40 keV had the highest pancreatic parenchymal CNR and attenuation difference between the adenocarcinoma and parenchyma, but also the highest noise (HUsd). Qualitatively, 70 keV had the best overall image quality (Mean [SE]: 3.7[0.1]) and lower noise than 40 and 55 keV (3.6[0.08] vs. 1.8[0.07] and 2.7[0.05], respectively, p < .001). 40 keV had the greatest pancreatic enhancement (mean[SE] 4.6[0.11]). Adenocarcinoma conspicuity ratings were greatest at 40 keV and 55 keV, and not significantly different from each other (mean[SE] 4.4[0.13] and 4.3[0.14], respectively, Tukey adj-p =.20). 55 keV had greater overall image quality and lower noise than 40 keV (mean[SE] 3.4[0.08] vs. 2.5[0.08], Tukey adj-p < .001 and 2.7[0.05] vs. 1.8[0.07], Tukey adj-p < .001 respectively).

Conclusion: 55 keV pancreatic parenchymal phase virtual monoenergetic images afford optimal pancreatic assessment at PCCT for the visualization of pancreatic adenocarcinoma. Routinely viewing 55 keV virtual monoenergetic images at PCCT may improve PDAC detection.

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光子计数CT在胰腺实质期检测胰腺腺癌的最佳虚拟单能量。

目的：胰腺是一个低对比度可见的器官，由于肿瘤与胰腺实质之间的细微衰减差异，胰腺导管腺癌的检测具有挑战性。光子计数CT （PCCT）具有比传统CT更好的碘噪比，也提供了低keV虚拟单能图像的创建，这两种图像都增加了腺癌的显著性。因此，目的是通过定量和定性分析，确定PCCT胰腺实质增强期PDAC可视化的最佳虚拟单能量。方法：采用PACS检索方法对连续的胰腺实质期PCCT患者的源资料进行回顾性分析。为了进行定量分析，在40-120 keV的虚拟单能量图像上以10 keV的增量在胰腺头部、身体、尾部、胰腺腺癌（如果存在）和腰肌中绘制感兴趣区域（ROI）测量。根据定量分析结果和供应商建议，选择四种虚拟单能量（40 keV, 55 keV， 70 keV和85 keV）进行额外的定性分析。三名放射科医生对四种虚拟单能量进行盲测，评估整体图像质量、图像噪声、胰腺增强和胰腺肿块显著性的5分李克特量表。结果：共纳入54例患者（男性28/54，平均[SD]年龄：62岁）。从数量上看，40 keV具有最高的胰腺实质CNR和腺癌与实质之间的衰减差，但噪声（HUsd）也最高。从质量上看，70 keV比40和55 keV（分别为3.6[0.08]比1.8[0.07]和2.7[0.05]）具有最好的整体图像质量（Mean [SE]: 3.7[0.1]）和更低的噪声。结论：55 keV胰腺实质期虚拟单能量图像在PCCT上对胰腺腺癌的可视化提供了最佳的胰腺评估。在PCCT上常规观察55kev虚拟单能图像可以提高PDAC的检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Abdominal Radiology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

8.30%

发文量

334

期刊介绍： Abdominal Radiology seeks to meet the professional needs of the abdominal radiologist by publishing clinically pertinent original, review and practice related articles on the gastrointestinal and genitourinary tracts and abdominal interventional and radiologic procedures. Case reports are generally not accepted unless they are the first report of a new disease or condition, or part of a special solicited section. Reasons to Publish Your Article in Abdominal Radiology: · Official journal of the Society of Abdominal Radiology (SAR) · Published in Cooperation with: European Society of Gastrointestinal and Abdominal Radiology (ESGAR) European Society of Urogenital Radiology (ESUR) Asian Society of Abdominal Radiology (ASAR) · Efficient handling and Expeditious review · Author feedback is provided in a mentoring style · Global readership · Readers can earn CME credits