One-Stop multienergy pancreatic dynamic volume perfusion imaging using photon-counting detector CT: Initial experience

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2025-06-27 DOI:10.1016/j.ejrad.2025.112268

Yanzhao Yang , Naiyi Zhu , Huimin Lin , Zhihan Xu , Rui Chang , Weimin Chai , Fuhua Yan

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引用次数: 0

Abstract

Purpose

This study reports initial experience with a modified one-stop, multienergy pancreatic VPCT protocol using PCCT, designed for comprehensive morphologic analysis and functional perfusion assessment of pancreatic ductal adenocarcinoma (PDAC).

Materials and Methods

From April 2024 to October 2024, participants with suspected PDAC were prospectively enrolled and underwent preoperative pancreatic dynamic VPCT. Individual phase images were extracted from perfusion datasets using T3D, virtual monoenergetic images (VMIs) at 55 and 70 keV reconstruction for diagnostic interpretation. Diagnostic image quality was assessed both quantitatively and subjectively. Perfusion maps were generated for analysis. Perfusion parameters were compared between PDAC lesions and normal parenchyma, as well as among PDAC histopathological differentiation. Radiation doses were recorded.

Results

A total of 65 participants (39 male; mean age, 66.2 ± 6.3 years) with histologically confirmed PDAC were included. The protocol achieved a mean effective radiation dose of 16.4 ± 4.5 mSv. All individual phase images met diagnostic quality standards (subjective scores ≥ 3). Among these, 55 keV VMIs demonstrated the highest CNR for PDAC lesions and adjacent vasculature, and superior subjective scores for lesion conspicuity in both pancreatic parenchymal and portal venous phases (all p < 0.05). Perfusion parameters, including blood flow (BF), blood volume (BV), time to drain (TTD), mean transit time, time to start, Tmax, and flow extraction product (FEP), differed significantly between PDAC lesions and normal parenchyma (all p < 0.05). Poorly differentiated PDAC lesions exhibited significantly lower BF, BV, TTD, and Tmax values and reduced lesion-to-parenchyma ratios of BF, BV, and FEP compared to moderately-to-well-differentiated PDAC lesions.

Conclusion

The one-stop, multienergy pancreatic VPCT protocol using PCCT enables high-quality morphologic imaging and reliable functional perfusion assessment at reduced radiation doses. It provides valuable insights into PDAC differentiation and histopathological grading, with potential implications for improved clinical management.

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利用光子计数检测器CT进行一站式多能胰腺动态体积灌注成像：初步经验

目的：本研究报告了一种改良的一站式、多能胰腺VPCT方案的初步经验，该方案采用PCCT，旨在对胰腺导管腺癌（PDAC）进行全面的形态学分析和功能灌注评估。材料与方法2024年4月至2024年10月，前瞻性纳入疑似PDAC患者，术前行胰腺动态VPCT。使用T3D、55和70 keV重建的虚拟单能图像（VMIs）从灌注数据集中提取单个相位图像，用于诊断解释。对诊断图像质量进行定量和主观评价。生成灌注图进行分析。比较PDAC病变与正常实质间及PDAC组织病理分化间的灌注参数。记录辐射剂量。结果共65例受试者，其中男性39例；平均年龄（66.2±6.3岁），组织学证实为PDAC。该方案的平均有效辐射剂量为16.4±4.5 mSv。所有个体相位图像均符合诊断质量标准（主观评分≥3）。其中，55个keV VMIs在PDAC病变和邻近血管方面的CNR最高，在胰腺实质和门静脉期的病变显著性方面的主观评分也较高(均p <；0.05)。灌注参数，包括血流量（BF）、血容量（BV）、引流时间（TTD）、平均传输时间、开始时间、Tmax和血流提取产物（FEP），在PDAC病变与正常实质之间存在显著差异(p <；0.05)。与中度分化至良好分化的PDAC病变相比，低分化的PDAC病变表现出明显较低的BF、BV、TTD和Tmax值，并且降低了BF、BV和FEP的病变与实质的比率。结论使用PCCT的一站式、多能胰腺VPCT方案在降低辐射剂量下可以实现高质量的形态学成像和可靠的功能灌注评估。它为PDAC的分化和组织病理学分级提供了有价值的见解，对改善临床管理具有潜在的意义。

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

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.