Haag Florian, Emmrich Shanice S, Hertel Alexander, Rink Johann, Vellala Abhinay, Komlen Sara, Nörenberg Dominik, Schoenberg Stefan O, Froelich Matthias F
Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
Abdom Radiol (NY). 2025 May 21. doi: 10.1007/s00261-025-04987-9.
To evaluate the potential of Photon counting CT (PCCT) -derived iodine densities and Virtual-Non-Contrast (VNC) reconstructions for the differentiation between adrenal adenomas and adrenal metastases.
This retrospective study enrolled 53 PCCT scans of patients with adrenal lesions (29 adenomas, 24 metastases) including early-arterial (ea) and portal-venous (pv) contrast phase. Iodine maps and VNC reconstructions were calculated from the acquired sequences. Using the measured values, several parameters such as relative enhancement (RE), normalized iodine density (NID), and iodine to VNC ratio (IVR) were calculated. In the acquired image series, iodine maps and VNC reconstructions density values were evaluated (adrenal lesion, ipsilateral adrenal tissue, contralateral adrenal tissue, portal vein, descending aorta, inferior vena cava, subcutaneous adipose tissue, in the first lumbar vertebral body, surrounding air, and in the psoas muscle) and compared.
In total, the measured structures showed significant variation in density values due to different contrast phases and reconstructions. VNC reconstructions of portal-venous contrast phase showed significant differences in measured density mean values between adrenal adenomas and adrenal metastases (21.64 HU vs. 28.26 HU, p: 0.027, AUC: 0.68). No significant differences between metastases and adenomas were observed in iodine concentration, RE of ea, NID of ea and pv, as IVR of ea. Significant alterations were observed in RE of pv (p: 0.023, AUC: 0.7) and IVR of pv (pv: 0.029, AUC: 0.69).
The recent study shows that PCCT derived VNC reconstructions of portal venous contrast phase can be used for reliable differentiation of adrenal adenomas and adrenal metastases and underlines the value of PCCT in oncological imaging.
评估光子计数CT（PCCT）得出的碘密度和虚拟平扫（VNC）重建在鉴别肾上腺腺瘤和肾上腺转移瘤方面的潜力。
这项回顾性研究纳入了53例肾上腺病变患者的PCCT扫描（29例腺瘤，24例转移瘤），包括动脉早期（ea）和门静脉期（pv）对比增强阶段。从采集的序列中计算碘图和VNC重建。利用测量值，计算了几个参数，如相对增强（RE）、归一化碘密度（NID）和碘与VNC比值（IVR）。在采集的图像序列中，评估碘图和VNC重建的密度值（肾上腺病变、同侧肾上腺组织、对侧肾上腺组织、门静脉、降主动脉、下腔静脉、皮下脂肪组织、第一腰椎椎体、周围空气和腰大肌）并进行比较。
总体而言，由于不同的对比增强阶段和重建方式，测量的结构在密度值上显示出显著差异。门静脉期对比增强的VNC重建在肾上腺腺瘤和肾上腺转移瘤之间的测量密度平均值存在显著差异（21.64 HU对28.26 HU，p：0.027，AUC：0.68）。在碘浓度、动脉早期的RE、动脉早期和门静脉期的NID以及动脉早期的IVR方面，转移瘤和腺瘤之间未观察到显著差异。在门静脉期的RE（p：0.023，AUC：0.7）和门静脉期的IVR（p：0.029，AUC：0.69）方面观察到显著变化。
最近的研究表明，门静脉期对比增强的PCCT衍生VNC重建可用于可靠鉴别肾上腺腺瘤和肾上腺转移瘤，并强调了PCCT在肿瘤成像中的价值。
