{"title":"利用胰腺灌注 CT 参数的相对评估来支持适当的胰腺腺癌诊断。","authors":"Yoshihiro Konno, Kazuho Takisawa, Masafumi Kanoto, Yoshiki Ishii, Yoshie Obata, Tetsuya Ishizawa, Akiko Matsuda, Yasuharu Kakizaki","doi":"10.1016/j.pan.2024.11.008","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect of relative evaluation of perfusion computed tomography (PCT) parameters in the diagnosis of pancreatic adenocarcinoma (PAC).</p><p><strong>Methods: </strong>Of the 117 patients in which PCT was performed (May 2019 to June 2023), 99 patients with mass lesions (MLs), including 50 PAC and 11 patients with mass-forming pancreatitis (MFP), and 15 patients without MLs but with main pancreatic duct (MPD) abnormalities, including 6 PAC and 7 no diagnosis of malignancy (NDM) cases were enrolled in this study. Parameter values were obtained from parametric maps of blood flow (BF), blood volume (BV), and mean transit time (MTT) for the ML and abnormal MPD part (AMP), pancreas and spleen. Diagnostic performance was evaluated based on receiver operating characteristic analysis for absolute values and relative values for pancreas and spleen.</p><p><strong>Results: </strong>BF<sub>ML</sub>, BV<sub>ML</sub>, BF<sub>ML/Pancreas</sub>, BF<sub>ML/Spleen</sub>, BV<sub>ML/Pancreas</sub> and BV<sub>ML/Spleen</sub> were significantly lower in PAC than MFP cases. Areas under the curve (AUCs) for BF<sub>ML</sub>, BF<sub>ML/Pancreas</sub>, BF<sub>ML/Spleen</sub> were 0.71 (sensitivity, 54 %; specificity, 91 %), 0.80 (sensitivity, 74 %; specificity, 82 %) and 0.79 (sensitivity, 68 %; specificity. 91 %), respectively. The AUCs for BV<sub>ML</sub>, BV<sub>ML/Pancreas</sub>, BV<sub>ML/Spleen</sub> were 0.72 (sensitivity, 48 %; specificity, 100 %), 0.85 (sensitivity, 76 %; specificity, 91 %) and 0.87 (sensitivity, 76 %; specificity, 91 %), respectively, with significantly better diagnostic performance on relative evaluation (P < 0.05). BV<sub>AMP/Spleen</sub> and MTT<sub>AMP/Spleen</sub> were significantly higher in PAC than NDM cases, with AUCs of 1 (100 % sensitivity and specificity) and 0.91 (sensitivity, 86 %; specificity, 100 %), respectively.</p><p><strong>Conclusions: </strong>Relative evaluation of PCT parameters is expected to contribute to more appropriate diagnosis of PAC.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Utilization of relative evaluation of pancreatic perfusion CT parameters to support appropriate pancreatic adenocarcinoma diagnosis.\",\"authors\":\"Yoshihiro Konno, Kazuho Takisawa, Masafumi Kanoto, Yoshiki Ishii, Yoshie Obata, Tetsuya Ishizawa, Akiko Matsuda, Yasuharu Kakizaki\",\"doi\":\"10.1016/j.pan.2024.11.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To investigate the effect of relative evaluation of perfusion computed tomography (PCT) parameters in the diagnosis of pancreatic adenocarcinoma (PAC).</p><p><strong>Methods: </strong>Of the 117 patients in which PCT was performed (May 2019 to June 2023), 99 patients with mass lesions (MLs), including 50 PAC and 11 patients with mass-forming pancreatitis (MFP), and 15 patients without MLs but with main pancreatic duct (MPD) abnormalities, including 6 PAC and 7 no diagnosis of malignancy (NDM) cases were enrolled in this study. Parameter values were obtained from parametric maps of blood flow (BF), blood volume (BV), and mean transit time (MTT) for the ML and abnormal MPD part (AMP), pancreas and spleen. Diagnostic performance was evaluated based on receiver operating characteristic analysis for absolute values and relative values for pancreas and spleen.</p><p><strong>Results: </strong>BF<sub>ML</sub>, BV<sub>ML</sub>, BF<sub>ML/Pancreas</sub>, BF<sub>ML/Spleen</sub>, BV<sub>ML/Pancreas</sub> and BV<sub>ML/Spleen</sub> were significantly lower in PAC than MFP cases. Areas under the curve (AUCs) for BF<sub>ML</sub>, BF<sub>ML/Pancreas</sub>, BF<sub>ML/Spleen</sub> were 0.71 (sensitivity, 54 %; specificity, 91 %), 0.80 (sensitivity, 74 %; specificity, 82 %) and 0.79 (sensitivity, 68 %; specificity. 91 %), respectively. The AUCs for BV<sub>ML</sub>, BV<sub>ML/Pancreas</sub>, BV<sub>ML/Spleen</sub> were 0.72 (sensitivity, 48 %; specificity, 100 %), 0.85 (sensitivity, 76 %; specificity, 91 %) and 0.87 (sensitivity, 76 %; specificity, 91 %), respectively, with significantly better diagnostic performance on relative evaluation (P < 0.05). BV<sub>AMP/Spleen</sub> and MTT<sub>AMP/Spleen</sub> were significantly higher in PAC than NDM cases, with AUCs of 1 (100 % sensitivity and specificity) and 0.91 (sensitivity, 86 %; specificity, 100 %), respectively.</p><p><strong>Conclusions: </strong>Relative evaluation of PCT parameters is expected to contribute to more appropriate diagnosis of PAC.</p>\",\"PeriodicalId\":19976,\"journal\":{\"name\":\"Pancreatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2024-11-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pancreatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.pan.2024.11.008\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pancreatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.pan.2024.11.008","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Utilization of relative evaluation of pancreatic perfusion CT parameters to support appropriate pancreatic adenocarcinoma diagnosis.
Objectives: To investigate the effect of relative evaluation of perfusion computed tomography (PCT) parameters in the diagnosis of pancreatic adenocarcinoma (PAC).
Methods: Of the 117 patients in which PCT was performed (May 2019 to June 2023), 99 patients with mass lesions (MLs), including 50 PAC and 11 patients with mass-forming pancreatitis (MFP), and 15 patients without MLs but with main pancreatic duct (MPD) abnormalities, including 6 PAC and 7 no diagnosis of malignancy (NDM) cases were enrolled in this study. Parameter values were obtained from parametric maps of blood flow (BF), blood volume (BV), and mean transit time (MTT) for the ML and abnormal MPD part (AMP), pancreas and spleen. Diagnostic performance was evaluated based on receiver operating characteristic analysis for absolute values and relative values for pancreas and spleen.
Results: BFML, BVML, BFML/Pancreas, BFML/Spleen, BVML/Pancreas and BVML/Spleen were significantly lower in PAC than MFP cases. Areas under the curve (AUCs) for BFML, BFML/Pancreas, BFML/Spleen were 0.71 (sensitivity, 54 %; specificity, 91 %), 0.80 (sensitivity, 74 %; specificity, 82 %) and 0.79 (sensitivity, 68 %; specificity. 91 %), respectively. The AUCs for BVML, BVML/Pancreas, BVML/Spleen were 0.72 (sensitivity, 48 %; specificity, 100 %), 0.85 (sensitivity, 76 %; specificity, 91 %) and 0.87 (sensitivity, 76 %; specificity, 91 %), respectively, with significantly better diagnostic performance on relative evaluation (P < 0.05). BVAMP/Spleen and MTTAMP/Spleen were significantly higher in PAC than NDM cases, with AUCs of 1 (100 % sensitivity and specificity) and 0.91 (sensitivity, 86 %; specificity, 100 %), respectively.
Conclusions: Relative evaluation of PCT parameters is expected to contribute to more appropriate diagnosis of PAC.
期刊介绍：
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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