title: Predictive value of dual-energy spectral computed tomographic imaging on the histological origin of carcinomas in the ampullary region.
abstract: OBJECTIVE
  To investigate the value of dual-energy spectral computed tomographic imaging (DESCT) to predict the origin of carcinomas in the ampullary region.
  
  
  METHODS
  Fifty-seven patients with suspected ampullary region carcinomas underwent DESCT prior to biopsy or surgery. Among those patients, 30 were pancreatic adenocarcinomas, 11 were biliary adenocarcinomas, 16 were adenocarcinomas of the ampulla diagnosed by biopsy and/or pathological examination before or after surgical operation. We compared the CT spectral imaging features among the adenocarcinomas with the above-mentioned three different origins.
  
  
  RESULTS
  Iodine concentration thresholds of 16.36, 21.86, and 21.86 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and pancreatic adenocarcinomas in the arterial phase (AP), portal venous phase (PP), and delayed phase (DP), respectively. Thresholds of 16.70, 24.33, and 26.43 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between common bile duct adenocarcinomas and ampullary adenocarcinomas in the AP, PP, and DP, respectively. Iodine concentration thresholds of 16.66 and 17.78 mg/mL yielded a sensitivity and specificity of 100% for distinguishing between ampullary adenocarcinomas and pancreatic adenocarcinomas in the PP and DP, respectively.
  
  
  CONCLUSIONS
  DESCT with multiple parameters can provide useful diagnostic information and may be used to predict the histological origin of carcinomas in the ampullary region.
authors.affiliation: Department of Radiology, Anhui Provincial Hospital Affiliated to Anhui Medical University, No. 17 Lujiang Road, Hefei, 230001, China, weiweill@126.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Wei
authors.forename: Yongqiang
authors.initials: Y
authors.lastname: Yu
authors.forename: Weifu
authors.initials: W
authors.lastname: Lv
authors.forename: Kexue
authors.initials: K
authors.lastname: Deng
authors.forename: Lei
authors.initials: L
authors.lastname: Yuan
authors.forename: Yingming
authors.initials: Y
authors.lastname: Zhao
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D014670:Ampulla of Vater / Q000000981:diagnostic imaging*; D003138:Common Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D055815:Young Adult