Quantitative and Qualitative Comparison of Single-Source Dual-Energy Computed Tomography and 120-kVp Computed Tomography for the Assessment of Pancreatic Ductal Adenocarcinoma

• Published in: Journal of computer assisted tomography Vol. 39; no. 6; p. 907
• Main Authors: Bhosale, Priya, Le, Ott, Balachandran, Aprana, Fox, Patricia, Paulson, Eric, Tamm, Eric
• Format: Journal Article
• Language: English
• Published: United States 01.11.2015
• Subjects: Adult; Aged; Carcinoma, Pancreatic Ductal - diagnostic imaging; Contrast Media; Female; Humans; Male; Middle Aged; Pancreas - diagnostic imaging; Pancreatic Neoplasms - diagnostic imaging; Radiographic Image Enhancement; Radiographic Image Interpretation, Computer-Assisted - methods; Signal-To-Noise Ratio; Tomography, X-Ray Computed - methods; Triiodobenzoic Acids
• ISSN: 1532-3145
• DOI: 10.1097/rct.0000000000000295

The aim of this study was to compare contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR) between pancreatic-phase dual-energy computed tomography (DECT) and 120-kVp CT for pancreatic ductal adenocarcinoma (PDA). Seventy-eight patients underwent multiphasic pancreatic imaging protocols for PDA (40, DECT; 38, 120-kVp CT [control]). Using pancreatic phase, CNR and SNR for PDA were obtained for DECT at monochromatic energies 50 through 80 keV, iodine material density images, and 120-kVp images. Using a 5-point scale (1, excellent; 5, markedly limited), images were qualitatively assessed by 2 radiologists in consensus for PDA detection, extension, vascular involvement, and noise. Wilcoxon signed rank and 2-sample tests were used to compare the qualitative measures, CNR and SNR, for DECT and 120-kVp images. Bonferroni correction was applied. Iodine material density image had significantly higher CNR and SNR for PDA than any monochromatic energy images (P < 0.0001) and the 120-kVp images. Qualitatively, 70-keV images were rated highest in the categories of tumor extension and vascular invasion and were similar to 120-kVp images. Our results indicate that DECT improves PDA lesion conspicuity compared with routine 120-kVp CT, which may allow for better detection of PDA.