Diagnostic and Interventional Radiology, Faculty of Medicine, University Hospital Augsburg, University of Augsburg, Stenglinstr. 2, 86156, Augsburg, Germany.
Centre for Advanced Analytics and Predictive Sciences (CAAPS), University of Augsburg, Universitätsstr. 2, 86159, Augsburg, Germany.
Abdom Radiol (NY). 2024 Jan;49(1):103-116. doi: 10.1007/s00261-023-04042-5. Epub 2023 Oct 5.
To analyze the conspicuity of pancreatic ductal adenocarcinoma (PDAC) in virtual monoenergetic images (VMI) on a novel photon-counting detector CT (PCD-CT) in comparison to energy-integrating CT (EID-CT).
Inclusion criteria comprised initial diagnosis of PDAC (reference standard: histopathological analysis) and standardized contrast-enhanced CT imaging either on an EID-CT or a PCD-CT. Patients were excluded due to different histopathological diagnosis or missing tumor delineation on CT. On the PCD-CT, 40-190 keV VMI reconstructions were generated. Image noise, tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) were analyzed by ROI-based measurements in arterial and portal venous contrast phase. Two board-certified radiologist evaluated image quality and tumor delineation at both, EID-CT and PCD-CT (40 and 70 keV).
Thirty-eight patients (mean age 70.4 years ± 10.3 [range 45-91], 27 males; PCD-CT: n=19, EID-CT: n=19) were retrospectively included. On the PCD-CT, tumor conspicuity (reflected by low TPR and high CNR) was significantly improved at low-energy VMI series (≤ 70 keV compared to > 70 keV), both in arterial and in portal venous contrast phase (P < 0.001), reaching the maximum at 40 keV. Comparison between PCD-CT and EID-CT showed significantly higher CNR on the PCD-CT in portal venous contrast phase at < 70 keV (P < 0.016). On the PCD-CT, tumor conspicuity was improved in portal venous contrast phase compared to arterial contrast phase especially at the lower end of the VMI spectrum (≤ 70 keV). Qualitative analysis revealed that tumor delineation is improved in 40 keV reconstructions compared to 70 keV reconstructions on a PCD-CT.
PCD-CT VMI reconstructions (≤ 70 keV) showed significantly improved conspicuity of PDAC in quantitative and qualitative analysis in both, arterial and portal venous contrast phase, compared to EID-CT, which may be important for early detection of tumor tissue in clinical routine. Tumor delineation was superior in portal venous contrast phase compared to arterial contrast phase.
分析新型光子计数探测器 CT（PCD-CT）上虚拟单能量图像（VMI）中胰腺导管腺癌（PDAC）的显影程度，并与能量积分 CT（EID-CT）进行比较。
纳入标准为初始 PDAC 诊断（参考标准：组织病理学分析）以及在 EID-CT 或 PCD-CT 上进行的标准化对比增强 CT 成像。由于不同的组织病理学诊断或 CT 上肿瘤描绘缺失，患者被排除在外。在 PCD-CT 上生成 40-190keV 的 VMI 重建。通过动脉期和门静脉期的 ROI 测量分析图像噪声、肿瘤-胰腺比（TPR）和对比噪声比（CNR）。两名具有董事会认证的放射科医生分别对 EID-CT 和 PCD-CT（40keV 和 70keV）的图像质量和肿瘤描绘进行评估。
回顾性纳入 38 名患者（平均年龄 70.4 岁±10.3[范围 45-91]，27 名男性；PCD-CT：n=19，EID-CT：n=19）。在 PCD-CT 上，低能量 VMI 系列（≤70keV 与＞70keV）肿瘤显影（通过低 TPR 和高 CNR 反映）显著改善，在动脉期和门静脉期均如此（P＜0.001），在 40keV 时达到最大值。PCD-CT 与 EID-CT 之间的比较显示，在门静脉期，低能量 VMI（＜70keV）时 PCD-CT 的 CNR 显著更高（P＜0.016）。在 PCD-CT 上，门静脉期肿瘤显影优于动脉期，尤其是在 VMI 谱的低端（≤70keV）。定性分析显示，与 70keV 重建相比，40keV 重建时 PCD-CT 上肿瘤描绘得到改善。
与 EID-CT 相比，PCD-CT VMI 重建（≤70keV）在动脉期和门静脉期的定量和定性分析中均显著提高了 PDAC 的显影程度，这可能对临床常规中肿瘤组织的早期检测很重要。与动脉期相比，门静脉期肿瘤描绘更好。
