title: Assessment of pancreatic adenocarcinoma: Use of low-dose whole pancreatic CT perfusion and individualized dual-energy CT scanning.
abstract: BACKGROUND
  The objective of this study was to investigate the value of low-dose whole pancreatic computed tomography (CT) perfusion integrated with individualized dual-energy CT (DECT) scanning in the diagnosis of pancreatic adenocarcinoma.
  
  
  METHODS
  Twenty patients with pancreatic adenocarcinoma underwent pancreatic CT perfusion as well as individualized dual-phase DECT pancreatic scans. Perfusion characteristics of non-tumourous pancreatic parenchyma and pancreatic adenocarcinoma were analysed. Weighted-average 120 kVp images and the optimal monoenergetic images in dual phase were reconstructed and the contrast noise ratio (CNR) of pancreas-to-tumour were compared.
  
  
  RESULTS
  There were significant difference on blood flow as well as blood volume between pancreatic adenocarcinoma and the non-tumourous pancreatic parenchyma (P < 0.05), whereas no difference on permeability (P > 0.05). CNRs of pancreas-to-tumour in individualized pancreatic phase were significantly higher than those in venous phase (P < 0.05), and CNRs of optimal monoenergetic images were higher than those on weighted-average 120 kVp images (P < 0.05) in both phase. Total effective radiation dose of CT examination was around 9.32-13.75 mSv.
  
  
  CONCLUSIONS
  Low-dose whole pancreatic CT perfusion can provide functional information, and the individualized pancreatic phase DECT scan is the optimal method for detecting pancreatic adenocarcinomas. The integration of the two techniques has great value in clinical application.
authors.affiliation: Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
authors.forename: Hai-ou
authors.initials: HO
authors.lastname: Li
authors.affiliation: Shandong Liaocheng Hospital, Shandong University, Liaocheng, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Guo
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Sun
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Li
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Yao-dong
authors.initials: YD
authors.lastname: Qi
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Xi-ming
authors.initials: XM
authors.lastname: Wang
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Zhuo-dong
authors.initials: ZD
authors.lastname: Xu
authors.affiliation: Medical Solutions Group, Siemens Ltd., Beijing, China.
authors.forename: Jiu-hong
authors.initials: JH
authors.lastname: Chen
authors.affiliation: Shandong Provincial Medical Imaging Research Institute, Shandong University, Jinan, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging*; D000328:Adult; D000368:Aged; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging*; D018802:Patient-Centered Care / Q000379:methods; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis*; D011835:Radiation Protection / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015900:Radiography, Dual-Energy Scanned Projection / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: computed tomography; diagnosis; dual-energy; pancreatic adenocarcinoma; perfusion