Dual-energy computed tomography as an alternative to computed tomography perfusion for assessment of pancreatic ductal adenocarcinoma.
4 affiliations
- 1Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
- 2Department of Biliary and Pancreatic Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China.
- 3Department of Radiology, Hefei First People's Hospital, Hefei, China.
- 4CT Imaging Research Center, GE HealthCare China, Shanghai, China.
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a poor prognosis. Computed tomography perfusion (CTP) can quantify tumor hemodynamic parameters. Dual-energy computed tomography (DECT) can quantify iodine concentration and may provide perfusion-related information. This study aimed to establish the relationship strength between DECT-derived iodine values and CTP-based parameters in PDAC. This study aimed to establish the relationship strength between DECT derived iodine values and CTP based parameters in PDAC. A total of 47 patients having histologically proven PDAC were enrolled in this study. These patients underwent multi-phase DECT scanning and concurrent dynamic CTP using a single source, fast kVp switching CT scanner. The DECT derived parameters and CTP derived parameters of pancreatic tumor and tumor-free pancreatic parenchyma were calculated, including iodine concentration (IC) and normalized iodine concentration (NIC) in the portal venous and delayed phases, as well as blood flow (BF), blood volume (BV), etc. Statistical different parameters between pancreatic tumor and tumor-free pancreatic parenchyma were analyzed by receiver-operating characteristic (ROC) curves. The diagnostic capability was determined by calculating the area under the curve (AUC). A paired t-test and Pearson correlation were used to evaluate the two techniques. For the tumor lesion, IC was 15.21±5.09 and 15.98±4.71 mg/mL in the portal venous and delayed phases, while NIC was 0.31±0.10 and 0.51±0.14. For the tumor-free pancreatic parenchyma, the corresponding values were 27.25±5.43 mg/mL and 21.67±5.23 mg/mL for IC, and 0.55±0.11 and 0.70±0.18 for NIC, respectively. For the tumor lesion, BF and BV were 30.25±11.80 mL/100 g/min and 3.53±2.42 mL/100 g, respectively. For the tumor-free pancreatic parenchyma, BF and BV were 109.74±56.79 mL/100 g/min and 10.77±2.84 mL/100 g, respectively. BF, BV, mean slope of increase (MSI), positive enhancement integral (PEI) and IC in portal venous phase (IC_VP), NIC in portal venous phase (NIC_VP) showed very high diagnostic accuracy (AUC: 0.957-0.981), while IC in delayed phase (IC_DP) and NIC in delayed phase (NIC_DP) demonstrated moderate accuracy. The IC_VP of the tumor lesions showed a moderate positive correlation with BF and BV (r=0.653 and r=0.461, respectively; both P<0.001). The NIC_VP of the tumor lesions also showed a moderate positive correlation with BF and BV (r=0.645 and r=0.491, respectively; both P<0.001). In PDAC tumor lesions, DECT derived IC and NIC both show moderate positive correlations with BF and BV, with stronger correlations observed for BF, enabling DECT to evaluate both morphological and perfusion changes.
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BibTeX
@article{ming2026dualenergy,
title = {{Dual-energy computed tomography as an alternative to computed tomography perfusion for assessment of pancreatic ductal adenocarcinoma.}},
author = {Shuai Ming and Yuanyuan Ruan and Peng Cheng and Dan Shi and Bin Wang and Jingyu Li and Minmin Du and Yiwen Zhang and Yuhang Yang and Hongji Zhu and Chenglin Zhu and Xiaoyong Zhang and Aiyun Sun and Wei Wei},
journal = {Journal of gastrointestinal oncology},
year = {2026},
month = sep,
doi = {10.21037/jgo-2026-0553},
url = {https://europepmc.org/article/MED/42996559},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Dual-energy computed tomography as an alternative to computed tomography perfusion for assessment of pancreatic ductal adenocarcinoma.
AU - Shuai Ming
AU - Yuanyuan Ruan
AU - Peng Cheng
AU - Dan Shi
AU - Bin Wang
AU - Jingyu Li
AU - Minmin Du
AU - Yiwen Zhang
AU - Yuhang Yang
AU - Hongji Zhu
AU - Chenglin Zhu
AU - Xiaoyong Zhang
AU - Aiyun Sun
AU - Wei Wei
PY - 2026
DA - 2026/09/28
JO - Journal of gastrointestinal oncology
DO - 10.21037/jgo-2026-0553
UR - https://europepmc.org/article/MED/42996559
AB - Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a poor prognosis. Computed tomography perfusion (CTP) can quantify tumor hemodynamic parameters. Dual-energy computed tomography (DECT) can quantify iodine concentration and may provide perfusion-related information. This study aimed to establish the relationship strength between DECT-derived iodine values and CTP-based parameters in PDAC. This study aimed to establish the relationship strength between DECT derived iodine values and CTP based parameters in PDAC. A total of 47 patients having histologically proven PDAC were enrolled in this study. These patients underwent multi-phase DECT scanning and concurrent dynamic CTP using a single source, fast kVp switching CT scanner. The DECT derived parameters and CTP derived parameters of pancreatic tumor and tumor-free pancreatic parenchyma were calculated, including iodine concentration (IC) and normalized iodine concentration (NIC) in the portal venous and delayed phases, as well as blood flow (BF), blood volume (BV), etc. Statistical different parameters between pancreatic tumor and tumor-free pancreatic parenchyma were analyzed by receiver-operating characteristic (ROC) curves. The diagnostic capability was determined by calculating the area under the curve (AUC). A paired t-test and Pearson correlation were used to evaluate the two techniques. For the tumor lesion, IC was 15.21±5.09 and 15.98±4.71 mg/mL in the portal venous and delayed phases, while NIC was 0.31±0.10 and 0.51±0.14. For the tumor-free pancreatic parenchyma, the corresponding values were 27.25±5.43 mg/mL and 21.67±5.23 mg/mL for IC, and 0.55±0.11 and 0.70±0.18 for NIC, respectively. For the tumor lesion, BF and BV were 30.25±11.80 mL/100 g/min and 3.53±2.42 mL/100 g, respectively. For the tumor-free pancreatic parenchyma, BF and BV were 109.74±56.79 mL/100 g/min and 10.77±2.84 mL/100 g, respectively. BF, BV, mean slope of increase (MSI), positive enhancement integral (PEI) and IC in portal venous phase (IC_VP), NIC in portal venous phase (NIC_VP) showed very high diagnostic accuracy (AUC: 0.957-0.981), while IC in delayed phase (IC_DP) and NIC in delayed phase (NIC_DP) demonstrated moderate accuracy. The IC_VP of the tumor lesions showed a moderate positive correlation with BF and BV (r=0.653 and r=0.461, respectively; both P<0.001). The NIC_VP of the tumor lesions also showed a moderate positive correlation with BF and BV (r=0.645 and r=0.491, respectively; both P<0.001). In PDAC tumor lesions, DECT derived IC and NIC both show moderate positive correlations with BF and BV, with stronger correlations observed for BF, enabling DECT to evaluate both morphological and perfusion changes.
SN - 2078-6891
SN - 2219-679X
ER -