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Simulated twin-phase pancreatic CT generated using single portal venous phase dual-energy CT acquisition in pancreatic ductal adenocarcinoma

  • Pancreas
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the diagnostic performance of a simulated twin-phase pancreatic protocol CT generated from a single portal venous phase (PVP) dual-energy CT (DECT) acquisition in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods

In this retrospective study, we included 63 patients with PDAC who underwent pancreatic protocol (pancreatic phase [PP] and PVP) DECT. Two data sets were created from this original acquisition—(1) Standard protocol (50 keV PP/65 keV PVP) and (2) Simulated protocol (40 keV/65 keV PVP). Using a 5-point scale, three readers scored image quality, tumor conspicuity, and arterial involvement by the PDAC. Signal-to-noise ratio (SNR) of the pancreas and tumor-to-pancreas contrast-to-noise ratio (CNR) were calculated. Qualitative scores, quantitative parameters, and radiation dose were compared between standard and simulated protocols.

Results

No significant difference in detection rate of PDAC was seen between the standard (58/63, 92.1%) and simulated protocols (56/63, 88.9%) (P = 0.76). Subjective scoring for arterial involvement for celiac (P = 0.86), superior mesenteric (P = 0.88), splenic (P = 0.86), common hepatic (P = 0.52), gastroduodenal (P = 0.95), first jejunal (P = 0.48) arteries, and aorta (P = 1.00) were comparable between two protocols. The image quality (P = 0.14), the SNR of the pancreas (P = 0.15), and CNR (P = 0.54) were comparable between two protocols. The projected mean dose-length product (DLP) (629.6 ± 148.3 mGy cm) in the simulated protocol showed a 44% reduction in radiation dose compared to the standard protocol (mean DLP, 1123.3 ± 268.9 mGy cm) (P < 0.0001).

Conclusions

Low keV images generated from a PVP DECT acquisition allows creation of a twin-phase pancreatic protocol CT with comparable diagnostic accuracy for detecting PDAC with significant reduction in radiation dose. Reduced radiation dose is desirable in surveillance and screening for pancreatic diseases.

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Abbreviations

ASiR:

Adaptive statistical iterative reconstruction

CNR:

Tumor-to-pancreas contrast-to-noise ratio

CT:

Computed tomography

DECT:

Dual-energy computed tomography

DLP:

Dose-length product

PDAC:

Pancreatic ductal adenocarcinoma

PP:

Pancreatic phase

PVP:

Portal venous phase

SNR:

Signal-to-noise ratio

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Authors and Affiliations

  1. Department of Radiology, Abdominal Imaging, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, White 270, Boston, MA, 02114, USA

    Yoshifumi Noda, Toru Tochigi, Anushri Parakh & Avinash Kambadakone

  2. Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan

    Yoshifumi Noda

  3. Department of Frontier Surgery, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba City, 260-8670, Japan

    Toru Tochigi

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  1. Yoshifumi Noda
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Correspondence to Avinash Kambadakone.

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AK: Grant support for research activities from Philips, GE Healthcare, and PanCAN. Other authors report no relevant disclosures or conflicts of interest.

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Noda, Y., Tochigi, T., Parakh, A. et al. Simulated twin-phase pancreatic CT generated using single portal venous phase dual-energy CT acquisition in pancreatic ductal adenocarcinoma. Abdom Radiol 46, 2610–2619 (2021). https://doi.org/10.1007/s00261-020-02921-9

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  • DOI: https://doi.org/10.1007/s00261-020-02921-9

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