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Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region

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Abdominal Imaging Aims and scope

Abstract

Purpose

To investigate the value of dual-energy spectral computed tomographic imaging (DESCT) to predict the origin of carcinomas in the ampullary region.

Materials and methods

Fifty-seven patients with suspected ampullary region carcinomas underwent DESCT prior to biopsy or surgery. Among those patients, 30 were pancreatic adenocarcinomas, 11 were biliary adenocarcinomas, 16 were adenocarcinomas of the ampulla diagnosed by biopsy and/or pathological examination before or after surgical operation. We compared the CT spectral imaging features among the adenocarcinomas with the above-mentioned three different origins.

Results

Iodine concentration thresholds of 16.36, 21.86, and 21.86 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and pancreatic adenocarcinomas in the arterial phase (AP), portal venous phase (PP), and delayed phase (DP), respectively. Thresholds of 16.70, 24.33, and 26.43 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and ampullary adenocarcinomas in the AP, PP, and DP, respectively. Iodine concentration thresholds of 16.66 and 17.78 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between ampullary adenocarcinomas and pancreatic adenocarcinomas in the PP and DP, respectively.

Conclusion

DESCT with multiple parameters can provide useful diagnostic information and may be used to predict the histological origin of carcinomas in the ampullary region.

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Abbreviations

CECT:

Contrast-enhanced CT

MRI:

Magnetic resonance imaging

DESCT:

Dual-energy spectral computed tomography

MD:

Material decomposition

ROI:

Regions of interest

AP:

Arterial phase

PP:

Portal venous phase

DP:

Delayed phase

ANOVA:

Analysis of variance

ROC:

Receiver operating characteristic

TP:

True positive

TN:

True negative

FP:

False positive

FN:

False negative

AUC:

Area under the curve

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Acknowledgments

We thank Na Gao, MD, Engineer of GE Healthcare, for technical assistance in this project.

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Authors and Affiliations

  1. Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, No. 17 Lujiang Road, Hefei, 230001, China

    Wei Wei, Weifu Lv, Kexue Deng, Lei Yuan & Yingming Zhao

  2. Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, 230022, China

    Yongqiang Yu

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  1. Wei Wei
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  2. Yongqiang Yu
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  3. Weifu Lv
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  4. Kexue Deng
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Correspondence to Yongqiang Yu.

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Wei, W., Yu, Y., Lv, W. et al. Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region. Abdom Imaging 39, 702–710 (2014). https://doi.org/10.1007/s00261-014-0098-9

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  • DOI: https://doi.org/10.1007/s00261-014-0098-9

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