Qihua Yin1, Xinnong Zou2, Xiaodong Zai3, Zhiyuan Wu4, Qingyang Wu5, Xingyu Jiang6, Hongwei Chen7, Fei Miao8. 1. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China; Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai 200025, China. Electronic address: yinqihuaphd@163.com. 2. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China. Electronic address: Zouxinnong@126.com. 3. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China. Electronic address: xdzhai3456@sina.com. 4. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai 200025, China. Electronic address: wzy11549@rjh.com.cn. 5. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China. Electronic address: qingyangwumd@163.com. 6. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China. Electronic address: zoezoejiang@163.com. 7. Department of Radiology, Wuxi People's Hospital, Nanjing Medical University, No. 299, Qingyang Road, Wuxi 214023, Jiangsu Province, China. Electronic address: chw6312@163.com. 8. Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No.197, Ruijin 2nd Road, Shanghai 200025, China. Electronic address: mf11066@rjh.com.cn.
Abstract
OBJECTIVE: To investigate the value of dual-energy MDCT in spectral imaging in the differential diagnosis of chronic mass-forming chronic pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) during the arterial phase (AP) and the pancreatic parenchymal phase (PP). MATERIALS AND METHODS: Thirty five consecutive patients with CMFP (n=15) or PDAC (n=20) underwent dual-energy MDCT in spectral imaging during AP and PP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PP, contrast-to-noise ratio (CNR) and the slope K of the spectrum curve were calculated. RESULTS: Normalized iodine concentrations (NICs) in patients with CMFP differed significantly from those in patients with PDAC during two double phases (mean NIC, 0.26±0.04 mg/mL vs. 0.53±0.02 mg/mL, p=0.0001; 0.07±0.02 mg/mL vs. 0.28±0.04 mg/mL, p=0.0002, respectively). There were significant differences in the value of the slope K of the spectrum curve in two groups during AP and PP (K(CMFP)=3.27±0.70 vs. K(PDAC)=1.35±0.41, P=0.001, and K(CMFP)=3.70±0.17 vs. K(PDAC)=2.16±0.70, p=0.003, respectively). CNRs at low energy levels (40-70 keV) were higher than those at high energy levels (80-40 keV). CONCLUSION: Individual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching.
OBJECTIVE: To investigate the value of dual-energy MDCT in spectral imaging in the differential diagnosis of chronic mass-forming chronic pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) during the arterial phase (AP) and the pancreatic parenchymal phase (PP). MATERIALS AND METHODS: Thirty five consecutive patients with CMFP (n=15) or PDAC (n=20) underwent dual-energy MDCT in spectral imaging during AP and PP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PP, contrast-to-noise ratio (CNR) and the slope K of the spectrum curve were calculated. RESULTS: Normalized iodine concentrations (NICs) in patients with CMFP differed significantly from those in patients with PDAC during two double phases (mean NIC, 0.26±0.04 mg/mL vs. 0.53±0.02 mg/mL, p=0.0001; 0.07±0.02 mg/mL vs. 0.28±0.04 mg/mL, p=0.0002, respectively). There were significant differences in the value of the slope K of the spectrum curve in two groups during AP and PP (K(CMFP)=3.27±0.70 vs. K(PDAC)=1.35±0.41, P=0.001, and K(CMFP)=3.70±0.17 vs. K(PDAC)=2.16±0.70, p=0.003, respectively). CNRs at low energy levels (40-70 keV) were higher than those at high energy levels (80-40 keV). CONCLUSION: Individual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching.
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