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

Abstract

To investigate the value of dual-energy spectral computed tomographic imaging (DESCT) to predict the origin of carcinomas in the ampullary region. 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. 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. DESCT with multiple parameters can provide useful diagnostic information and may be used to predict the histological origin of carcinomas in the ampullary region.