Insulinoma detection on low-dose pancreatic CT perfusion: comparing with conventional contrast-enhanced CT and MRI.

IF 4.1 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Shiwei Luo, Xilong Mei, Youlan Shang, Jiaqi Yao, Nuerbiya Keranmu, Shaqi He, Cheng Yu, Fei Tang, Cong Li, Wenhan Yang, Jun Liu
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引用次数: 0

Abstract

Objectives: To evaluate the efficacy of low-dose pancreatic CT perfusion (pCTP) in detecting insulinomas in patients with recurrent hypoglycemia, and to compare its diagnostic performance with conventional contrast-enhanced CT (CECT) and MRI.

Methods: This study retrospectively collected 53 patients with recurrent hypoglycemia (28 with insulinomas; 25 without insulinomas). PCTP image analysis was conducted by two radiologists. Quantitative perfusion parameters of insulinomas vs. tumor-free pancreatic parenchyma were analyzed. For cases where both pCTP and CECT/MRI were performed, six radiologists blinded to the patients' diagnosis independently evaluated the pCTP and CECT/MRI to determine the presence and location of insulinoma. The diagnostic performance of insulinoma detection between pCTP and CECT/MRI was compared.

Results: For patients who underwent both CECT and pCTP, the sensitivity (CECT 0.167-0.333 vs. pCTP 0.667-1.000) of tumor detection was higher for five of six radiologists on pCTP than on CECT. For patients who underwent both MRI and pCTP, four radiologists showed higher sensitivity (MRI 0.400-600 vs. pCTP 0.700-0.800) of tumor detection on pCTP than on MRI, while two radiologists showed slightly lower sensitivity (MRI 0.800, 1.000 vs. pCTP 0.700, 0.900) on pCTP. Among perfusion parameters, peak enhancement, blood flow, and mean transit time exhibited higher AUC than blood volume and time to peak.

Conclusion: PCTP demonstrated superior diagnostic performance in insulinoma detection among less-experienced radiologists compared to CECT and MRI, while more-experienced radiologists achieved marginally better results with MRI. These findings suggest pCTP's potential as a complementary imaging modality, particularly beneficial for junior radiologists in insulinoma detection.

Critical relevance statement: Pancreatic CT perfusion exhibited promising diagnostic performance in insulinoma detection, particularly among junior radiologists, demonstrating the potential to complement conventional imaging modalities and serve as a valuable clinical tool for the detection and localization of insulinoma.

Key points: Accurate preoperative identification and localization of insulinomas is important for appropriate treatment. Peak enhancement, blood flow, and mean transit time outperformed blood volume and time to peak in insulinoma detection. Pancreatic CT perfusion has the potential to complement conventional imaging modalities for insulinoma detection.

胰腺低剂量CT灌注检测胰岛素瘤:与常规CT增强和MRI对比。
目的:探讨低剂量胰腺CT灌注检查(pCTP)对复发性低血糖患者胰岛素瘤的诊断价值,并与常规CT增强检查(CECT)和MRI检查进行比较。方法:本研究回顾性收集53例复发性低血糖患者(28例伴有胰岛素瘤;25例无胰岛素瘤)。PCTP图像分析由两名放射科医生进行。分析胰岛素瘤与无瘤胰腺实质的定量灌注参数。对于同时进行了pCTP和CECT/MRI的病例,六位不知道患者诊断的放射科医生独立评估pCTP和CECT/MRI以确定胰岛素瘤的存在和位置。比较pCTP与CECT/MRI对胰岛素瘤的诊断价值。结果:对于同时接受CECT和pCTP的患者,6名放射科医生中有5名使用pCTP的肿瘤检测灵敏度(CECT 0.167-0.333 vs. pCTP 0.667-1.000)高于使用CECT的患者。对于同时接受MRI和pCTP的患者,4名放射科医生对pCTP肿瘤检测的敏感性高于MRI (MRI 0.400-600 vs. pCTP 0.700-0.800), 2名放射科医生对pCTP的敏感性略低于MRI (MRI 0.800, 1.000 vs. pCTP 0.700, 0.900)。在灌注参数中,峰值增强、血流量和平均传递时间的AUC高于血容量和峰值时间。结论:相对于CECT和MRI,在经验不足的放射科医生中,PCTP在胰岛素瘤检测中表现出更好的诊断性能,而经验丰富的放射科医生在MRI中取得了略好的结果。这些发现表明,pCTP作为一种补充成像方式的潜力,尤其有利于初级放射科医生检测胰岛素瘤。关键相关声明:胰腺CT灌注在胰岛素瘤检测中显示出有希望的诊断性能,特别是在初级放射科医生中,显示出补充传统成像方式的潜力,并作为胰岛素瘤检测和定位的有价值的临床工具。重点:术前对胰岛素瘤的准确识别和定位是正确治疗的关键。在胰岛素瘤检测中,峰值增强、血流量和平均传输时间优于血容量和峰值时间。胰腺CT灌注有可能补充胰岛素瘤检测的传统成像方式。
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来源期刊
Insights into Imaging
Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
7.30
自引率
4.30%
发文量
182
审稿时长
13 weeks
期刊介绍: Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.
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