Abstract
ObjectiveTo investigate the value of dual-energy MDCT in spectral imaging in the differential diagnosis of chronic mass-forming chronic pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) during the arterial phase (AP) and the pancreatic parenchymal phase (PP). Materials and methodsThirty five consecutive patients with CMFP (n=15) or PDAC (n=20) underwent dual-energy MDCT in spectral imaging during AP and PP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PP, contrast-to-noise ratio (CNR) and the slope K of the spectrum curve were calculated. ResultsNormalized iodine concentrations (NICs) in patients with CMFP differed significantly from those in patients with PDAC during two double phases (mean NIC, 0.26±0.04mg/mL vs. 0.53±0.02mg/mL, p=0.0001; 0.07±0.02mg/mL vs. 0.28±0.04mg/mL, p=0.0002, respectively). There were significant differences in the value of the slope K of the spectrum curve in two groups during AP and PP (KCMFP=3.27±0.70 vs. KPDAC=1.35±0.41, P=0.001, and KCMFP=3.70±0.17 vs. KPDAC=2.16±0.70, p=0.003, respectively). CNRs at low energy levels (40–70keV) were higher than those at high energy levels (80–40keV). ConclusionIndividual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching.
Published Version
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