Multidetector computer tomography in the pancreatic adenocarcinoma assessment: an update

Abstract

Ductal adenocarcinoma of the pancreas is one of the most aggressive forms of cancer, with only a minority of cases being resectable at the moment of their diagnosis. The accurate detection and characterization of pancreatic carcinoma is very important for patient management. Multidetector-row computed tomography (MDCT) has become the cross-sectional modality of choice in the diagnosis, staging, treatment planning, and follow-up of patients with pancreatic tumors. However, approximately 11% of ductal adenocarcinomas still remain undetected at MDCT because of the lack of attenuation gradient between the lesion and the adjacent pancreatic parenchyma. In this systematic literature review we investigate the current evolution of the CT technique, limitations, and perspectives in the evaluation of pancreatic carcinoma.

Treatment planning based on water density image generated using dual‐energy computed tomography for pancreatic cancer with contrast‐enhancing agent: Phantom and clinical study

“…To our knowledge, this is the first study to implement WDI‐based treatment planning for pancreatic cancer patients by using a contrast‐enhancing agent. Commonly, contrast‐enhanced images were acquired in the pancreatic phase (35–45 s after the injection) to detect pancreatic tumor because tumor‐to‐gland attenuation differences were the largest in this phase . The oral contrast‐enhancing agent containing iodine material was also useful for distinguishing the radiosensitive OARs (duodenum, stomach, and bowel) from the pancreas.…”

“…Commonly, contrast-enhanced images were acquired in the pancreatic phase (35-45 s after the injection) to detect pancreatic tumor because tumor-to-gland attenuation differences were the largest in this phase. 21 The oral contrast-enhancing agent containing iodine material was also useful for distinguishing the radiosensitive OARs (duodenum, stomach, and bowel) from the pancreas. In such images, the tissues (vessels, kidneys, and so on) were strongly enhanced by the iodine material, and the difference in the HU values between the contrastenhanced image and the unenhanced image might be considerably large.…”

Pancreatic Cancer Imaging: What the Surgeon Wants to Know?

“…Granata et al discussed the importance of the parenchymal pancreatic phase using the dual-energy MDCT and the perfusion CT in visualizing the undetected tumors due to lack of attenuation gradient between the tumor and the surrounding parenchyma. 30 CT images can be viewed at multiple energy levels on dual-energy CT, which also allows the generation of iodine images and virtual noncontrast (water only) CT images. Iodine images increase lesion conspicuity, improve pancreatic cancer detection (►Fig.…”

Improved detectability of hypoattenuating focal pancreatic lesions by dual-layer computed tomography using virtual monoenergetic images

“…Over the past several years, efforts have been directed to utilizing dual-energy CT (DECT) as an optimal advance of CT technology to improve pancreatic tumor detectability [13][14][15][16]. DECT uses two different x-ray energy peaks to acquire images.…”