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Dual-energy CT improves differentiation of non-hypervascular pancreatic neuroendocrine neoplasms from CA 19-9-negative pancreatic ductal adenocarcinomas

  • Abdominal Radiology
  • Published:
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Abstract

Purpose

To evaluate the utility of dual-energy CT (DECT) in differentiating non-hypervascular pancreatic neuroendocrine neoplasms (PNENs) from pancreatic ductal adenocarcinomas (PDACs) with negative carbohydrate antigen 19–9 (CA 19-9).

Methods

This retrospective study included 26 and 39 patients with pathologically confirmed non-hypervascular PNENs and CA 19-9-negative PDACs, respectively, who underwent contrast-enhanced DECT before treatment between June 2019 and December 2021. The clinical, conventional CT qualitative, conventional CT quantitative, and DECT quantitative parameters of the two groups were compared using univariate analysis and selected by least absolute shrinkage and selection operator regression (LASSO) analysis. Multivariate logistic regression analyses were performed to build qualitative, conventional CT quantitative, DECT quantitative, and comprehensive models. The areas under the receiver operating characteristic curve (AUCs) of the models were compared using DeLong’s test.

Results

The AUCs of the DECT quantitative (based on normalized iodine concentrations [nICs] in the arterial and portal venous phases: 0.918; 95% confidence interval [CI] 0.852–0.985) and comprehensive (based on tumour location and nICs in the arterial and portal venous phases: 0.966; 95% CI 0.889–0.995) models were higher than those of the qualitative (based on tumour location: 0.782; 95% CI 0.665–0.899) and conventional CT quantitative (based on normalized conventional CT attenuation in the arterial phase: 0.665; 95% CI 0.533–0.797; all P < 0.05) models. The DECT quantitative and comprehensive models had comparable performances (P = 0.076).

Conclusions

Higher nICs in the arterial and portal venous phases were associated with higher blood supply improving the identification of non-hypervascular PNENs.

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Acknowledgements

Dr. Yuan Lin and Ling Xue (experts in pathology, The First Affiliated Hospital, Sun Yat-Sen University, China) provided the pathological analysis for this manuscript.

Funding

This study received funding from the National Natural Science Foundation of China (81801761 to Yanji Luo).

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Author notes

  1. Xuefang Hu and Siya Shi have contributed equally to this work and should be considered co-first authors.

Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2, Guangzhou, 510080, Guangdong, China

    Xuefang Hu, Siya Shi, Yangdi Wang, Jiaxin Yuan, Mingjie Chen, Luyong Wei, Shi-Ting Feng, Zhenpeng Peng & Yanji Luo

  2. Department of Radiology, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, 518000, Guangdong, China

    Xuefang Hu

  3. Clinical and Technical Support, Philips Healthcare China, Shanghai, 200072, China

    Weiwei Deng

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  1. Xuefang Hu
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Contributions

All authors contributed to the study conception and design. Material preparation and data collection and analysis were performed by XH, SS, and YW. The first draft of the manuscript was written by XH, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Zhenpeng Peng or Yanji Luo.

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Conflict of interest

Weiwei Deng from Philips Healthcare provided technical support but has no conflict of interest. The other authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Ethical approval

The ethics committee of the First Affiliated Hospital, Sun Yat-Sen University, approved this retrospective single-centre study, and the requirement for informed consent was waived (Approval No.: 2021 [721]).

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Hu, X., Shi, S., Wang, Y. et al. Dual-energy CT improves differentiation of non-hypervascular pancreatic neuroendocrine neoplasms from CA 19-9-negative pancreatic ductal adenocarcinomas. Radiol med 129, 1–13 (2024). https://doi.org/10.1007/s11547-023-01733-3

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