title: Dual-source dual-energy MDCT of pancreatic adenocarcinoma: initial observations with data generated at 80 kVp and at simulated weighted-average 120 kVp.
abstract: OBJECTIVE
  The purpose of this study was to determine whether the conspicuity of malignant tumors of the pancreas at dual-source dual-energy CT is better with 80-kVp acquisition than with 120-kVp acquisition simulated with a weighted average.
  
  
  METHODS
  Fifteen patients with pancreatic adenocarcinoma underwent contrast-enhanced dual-source dual-energy CT. The abdominal diameter of all patients was 35 cm or less. Data were reconstructed as a weighted average of the 140- and 80-kVp acquisitions, simulating 120 kVp, and as a pure 80-kVp data set. A region-of-interest cursor was placed within the tumor and the adjacent normal parenchyma, and attenuation differences and contrast-to-noise ratios were calculated for pancreatic tumors at 80 kVp and with the weighted-average acquisition. The 80-kVp and weighted-average images were subjectively compared in terms of lesion conspicuity, image quality, and duct visualization. An exact Wilcoxon's matched pairs signed rank test was used to test whether differences in attenuation, contrast-to-noise ratio, and subjective assessment were greater at 80 kVp.
  
  
  RESULTS
  The mean difference in attenuation for each pancreatic tumor and adjacent portion of normal pancreas was 83.27+/-29.56 (SD) HU at 80 kVp and 49.40+/-23.00 HU at weighted-average 120 kVp. Adenocarcinoma attenuation differences were significantly greater at 80 kVp than at 120 kVp (p=0.00006). Contrast-to-noise ratio was significantly higher at 80 kVp than at 120 kVp (p=0.00147). Subjective analysis showed lesion conspicuity (p=0.001) and duct visualization (p=0.0156) were significantly better on the 80-kVp images.
  
  
  CONCLUSIONS
  At portal venous phase dual-source dual-energy CT, the conspicuity of malignant tumors of the pancreas is greater at 80 kVp than with weighted-average acquisition.
authors.affiliation: Department of Radiology, New York University School of Medicine, NYU Medical Center, 560 First Ave., Ste. HW-202, New York, NY 10016, USA. michael.macari@nyumc.org
authors.forename: Michael
authors.initials: M
authors.lastname: Macari
authors.forename: Bradley
authors.initials: B
authors.lastname: Spieler
authors.forename: Danny
authors.initials: D
authors.lastname: Kim
authors.forename: Anno
authors.initials: A
authors.lastname: Graser
authors.forename: Alec Jeffrey
authors.initials: AJ
authors.lastname: Megibow
authors.forename: James
authors.initials: J
authors.lastname: Babb
authors.forename: Hersh
authors.initials: H
authors.lastname: Chandarana
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide