Iodine concentration and tissue attenuation in dual-energy contrast-enhanced CT as a potential quantitative parameter in early detection of local pancreatic carcinoma recurrence after surgical resection

• Verfasst von: Mathy, René Michael [VerfasserIn]
• Verfasst von: Fritz, Franziska [VerfasserIn]
• Verfasst von: Mayer, Philipp [VerfasserIn]
• Verfasst von: Klauß, Miriam [VerfasserIn]
• Verfasst von: Grenacher, Lars [VerfasserIn]
• Verfasst von: Stiller, Wolfram [VerfasserIn]
• Verfasst von: Kauczor, Hans-Ulrich [VerfasserIn]
• Verfasst von: Skornitzke, Stephan [VerfasserIn]
• Titel: Iodine concentration and tissue attenuation in dual-energy contrast-enhanced CT as a potential quantitative parameter in early detection of local pancreatic carcinoma recurrence after surgical resection
• Verf.angabe: René Michael Mathy, Franziska Fritz, Philipp Mayer, Miriam Klauss, Lars Grenacher, Wolfram Stiller, Hans-Ulrich Kauczor, Stephan Skornitzke
• E-Jahr: 2021
• Jahr: October 2021
• Umfang: 7 S.
• Fussnoten: Gesehen am 20.10.2021
• Titel Quelle: Enthalten in: European journal of radiology
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1990
• Jahr Quelle: 2021
• Band/Heft Quelle: 143(2021) vom: Okt., Artikel-ID 109944, Seite 1-7
• ISSN Quelle: 1872-7727
• DOI: doi:10.1016/j.ejrad.2021.109944
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Computed tomography
• Sach-SW: Dual-energy CT
• Sach-SW: Iodine concentration
• Sach-SW: Pancreatic carcinoma recurrence
• Sach-SW: Postoperative soft tissue formation
• K10plus-PPN: 1774607034

Abstract

Purpose - Due to the difficult differentiation from non-specific postoperative soft tissue formation (PSF), early diagnosis of pancreatic carcinoma recurrence remains challenging. Thus, we investigated the diagnostic potential of dual-energy (DE) contrast-enhanced CT. - Method - After potentially curative pancreatic carcinoma resection, 31 consecutive patients with PSF were examined via DE perfusion CT, acquiring 34 images (80 kVp/140 kVp) every 1.5 s, as the initial purpose of this study was evaluating CT-Perfusion. Corresponding time points of arterial, pancreatic, and early venous phase were calculated from bolus trigger times in prior conventional CT. Iodine and 120 kVp-equivalent images were calculated. Regions of interest were placed in each soft tissue formation. Diagnosis of local recurrence was confirmed by regular follow-up or histopathology. - Results - Final diagnosis was local recurrence in 17 patients and non-specific PSF in 14 patients. Iodine concentrations in early venous phase were significantly higher in recurrent carcinoma than in non-specific PSF (1.47 mg/ml vs. 0.96 mg/ml, p = 0.007). In earlier contrast phases iodine concentrations tended to be higher, but not significantly. CT numbers in recurrent carcinoma in 120 kVp-equivalent images in venous phase were significantly higher, too (74HU vs 47HU, p = 0.002). ROC-curve analysis for iodine concentrations in early venous phase suggests a cut-off value of ≥ 1.55 mg/ml for local recurrence (AUC = 0.78, specificity = 1.0, sensitivity = 0.53) and for CT numbers in 120kVp-equivalent images a cut-off value of ≥ 57HU (AUC = 0.82, specificity = 0.82, sensitivity = 0.71). - Conclusion - In difficult cases, measuring iodine concentrations or CT numbers in PSF in (early) venous phase DECT could be a valuable additional parameter for differentiating local recurrence from non-specific PSF.