Pancreatic adenocarcinoma: a comparison of automatic bolus tracking and empirical scan delay.
BACKGROUND
To evaluate the efficacy of automatic bolus tracking in multidetector row CT (MDCT) for pancreatic adenocarcinoma as compared with standard scan delay using the fixed duration contrast injection technique.


METHODS
Seventy-nine patients with pancreatic adenocarcinomas underwent three-phase enhanced CT with an individualized scan delay as determined by automatic bolus tracking (protocol 1) or an empiric scan delay (protocol 2). We evaluated enhancement of the aorta, portal vein, hepatic parenchyma, pancreatic parenchyma, and pancreatic adenocarcinoma during each phase. Two radiologists graded the conspicuity of pancreatic adenocarcinoma in the pancreatic parenchymal phase. The results for the different groups were statistically compared.


RESULTS
Pancreatic parenchymal enhancement (mean ± standard deviation, 100.2 HU ± 17.6 vs. 88.5 HU ± 22.1; P < 0.05) and tumor-to-pancreas contrast (mean ± standard deviation, 75.3 HU ± 25.0 vs. 63.1 HU ± 24.1; P < 0.05) were significantly greater in protocol 1 than in protocol 2 during pancreatic parenchymal phase. Qualitative results correlated well with quantitative results (reviewer 1: R (s) = 0.78, P < 0.001; reviewer 2: R (s) = 0.66, P < 0.001)


CONCLUSIONS
The use of automatic bolus tracking with MDCT can significantly improve the degree of contrast enhancement in the pancreatic parenchyma and tumor-to-pancreas conspicuity.
Fukukura
Yoshihiko
Y
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, 890-8544, Japan. yoshihiko2002jp@yahoo.co.jp
Takumi
Koji
K
Kamiyama
Takuro
T
Shindo
Toshikazu
T
Higashi
Ryutaro
R
Nakajo
Masayuki
M
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011446:Prospective Studies; D011857:Radiographic Image Interpretation, Computer-Assisted; D018709:Statistics, Nonparametric; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
D014408:Biomarkers, Tumor; D003287:Contrast Media