PMID- 31312889
OWN - NLM
STAT- MEDLINE
DCOM- 20200312
LR  - 20211020
IS  - 1432-1084 (Electronic)
IS  - 0938-7994 (Linking)
VI  - 30
IP  - 1
DP  - 2020 Jan
TI  - Dual-layer spectral CT improves image quality of multiphasic pancreas CT in 
      patients with pancreatic ductal adenocarcinoma.
PG  - 394-403
LID - 10.1007/s00330-019-06337-y [doi]
AB  - OBJECTIVES: To evaluate the image quality and optimal energies of virtual 
      monoenergetic images (VMIs) from dual-layer spectral detector computed tomography 
      (DLCT) in multiphasic pancreatic CT and investigate whether low-keV VMI at the 
      portal venous phase (PVP) provides sufficient tumor conspicuity and arterial 
      depiction relative to conventional pancreatic parenchymal phase (PPP) images. 
      METHODS: Forty-eight patients with pancreatic ductal adenocarcinoma (PDAC) 
      underwent contrast-enhanced DLCT during PPP and PVP. Conventional polyenergetic 
      images (PEIs) and VMI at 40-100 keV (VMI(40-100), 10-keV increments) were 
      reconstructed at each enhancement phase. Image noise and the contrast-to-noise 
      ratio (CNR) of the pancreas, tumors, arteries, and veins were quantified. Two 
      radiologists independently assessed tumor conspicuity, margin delineation, image 
      noise, sharpness of pancreatic duct, and depiction of arteries and veins on a 
      five-point scale. Size-specific dose estimate (SSDE) was calculated. RESULTS: 
      Image noise for VMI(40-100) was significantly lower than that for PEI (p < 0.01). 
      The CNR in VMI increased gradually with decreasing energy; CNRs for VMI(40-60) 
      were significantly greater than that for PEI (p < 0.01). All subjective VMI 
      scores were maximized at VMI(40), followed by VMI(50-60), all of which were 
      significantly better than of PEI (p < 0.01). Objective and subjective image 
      qualities of VMI(40-50) at the PVP were equivalent to or even better compared 
      with conventional PPP images. No significant difference in SSDE was observed 
      between phases (p = 0.10). CONCLUSIONS: DLCT-VMI improved the subjective and 
      objective image quality in multiphasic pancreatic CT for patients with PDAC. 
      Low-keV PVP imaging may yield diagnostically adequate tumor conspicuity and 
      arterial assessment compared with polyenergetic PPP images. KEY POINTS: * Low-keV 
      VMI from DLCT yields better subjective and objective image quality of multiphasic 
      pancreas CT in comparison with conventional PEI for the assessment of pancreatic 
      ductal adenocarcinoma. * Tumor conspicuity and depiction of peripancreatic 
      vasculature were maximized at VMI (40)without an increase in the image noise. * 
      Low-keV VMI of the portal venous phase provides sufficient tumor conspicuity and 
      arterial depiction, potentially allowing the early detection and local staging of 
      PDAC on routine abdominal CT performed for various clinical indications.
FAU - Nagayama, Yasunori
AU  - Nagayama Y
AUID- ORCID: 0000-0003-3280-7346
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan. 
      y.nagayama1980@gmail.com.
FAU - Tanoue, Shota
AU  - Tanoue S
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
FAU - Inoue, Taihei
AU  - Inoue T
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
FAU - Oda, Seitaro
AU  - Oda S
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
FAU - Nakaura, Takeshi
AU  - Nakaura T
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
FAU - Utsunomiya, Daisuke
AU  - Utsunomiya D
AD  - Department of Diagnostic Radiology, Yokohama City University Hospital, 3-9 
      Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan.
FAU - Yamashita, Yasuyuki
AU  - Yamashita Y
AD  - Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto 
      University, 1-1-1, Honjo, Chuo-ku, Kumamoto, 860-8556, Japan.
LA  - eng
PT  - Journal Article
DEP - 20190716
PL  - Germany
TA  - Eur Radiol
JT  - European radiology
JID - 9114774
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Carcinoma, Pancreatic Ductal/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pancreas/*diagnostic imaging
MH  - Pancreatic Neoplasms/*diagnostic imaging
MH  - Radiography, Dual-Energy Scanned Projection/*methods
MH  - Retrospective Studies
MH  - Signal-To-Noise Ratio
MH  - Tomography, X-Ray Computed/*methods
OTO - NOTNLM
OT  - Dual-energy scanned projection radiography
OT  - Image enhancement
OT  - Multidetector computed tomography
OT  - Pancreas cancer
EDAT- 2019/07/18 06:00
MHDA- 2020/03/13 06:00
CRDT- 2019/07/18 06:00
PHST- 2019/04/17 00:00 [received]
PHST- 2019/06/21 00:00 [accepted]
PHST- 2019/05/30 00:00 [revised]
PHST- 2019/07/18 06:00 [pubmed]
PHST- 2020/03/13 06:00 [medline]
PHST- 2019/07/18 06:00 [entrez]
AID - 10.1007/s00330-019-06337-y [pii]
AID - 10.1007/s00330-019-06337-y [doi]
PST - ppublish
SO  - Eur Radiol. 2020 Jan;30(1):394-403. doi: 10.1007/s00330-019-06337-y. Epub 2019 
      Jul 16.