Pancreatic ductal adenocarcinoma and chronic mass-forming pancreatitis: Differentiation with dual-energy MDCT in spectral imaging mode

Yin, Qiang; Zou, Xinnong; Zai, Xiaodong; Wu, Zhiyuan; Wu, Qingping; Jiang, Xingyu; Chen, Hongwei; Miao, Fei

doi:10.1016/j.ejrad.2015.09.023

Cited by 61 publications

(53 citation statements)

References 34 publications

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“…The development of multidetector computerized tomography (CT) has improved the accuracy of CT in diagnosing CP and pancreatic neoplasms; however, the improved accuracy is only in cases where there is focal enlargement of the pancreas, which occurs in approximately 30% of CP cases, and these disorders have several overlapping morphologic features that limit its application [39]. Indeed, diagnosing CP by imaging techniques can miss cases in which morphological changes are not very prominent [37]; however, declining pancreatic exocrine secretion may precede detectable morphological changes [40].…”

Section: Diagnosis and Standard Of Care In Patients Presenting With Smentioning

confidence: 98%

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Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test

et al. 2017

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The early diagnosis of pancreatic exocrine insufficiency (PEI) is hindered because many of the functional diagnostic techniques used are expensive and require specialized facilities, which prevent their widespread availability. We have reviewed current evidence in order to compare the utility of these functional diagnostic techniques with the fecal elastase-1 (FE-1) test in the following three scenarios: screening for PEI in patients presenting with symptoms suggestive of pancreatic disease, such as abdominal pain or diarrhea; determining the presence of PEI in patients with an established diagnosis of pancreatic disease, such as chronic pancreatitis or cystic fibrosis; determining exocrine status in disorders not commonly tested for PEI, but which have a known association with this disorder. Evidence suggests the FE-1 test is reliable for the evaluation of pancreatic function in many pancreatic and non-pancreatic disorders. It is non-invasive, is less time-consuming, and is unaffected by pancreatic enzyme replacement therapy. Although it cannot be considered the gold-standard method for the functional diagnosis of PEI, the advantages of the FE-1 test make it a very appropriate test for screening patients who may be at risk of this disorder.

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Section: Diagnosis and Standard Of Care In Patients Presenting With Smentioning

confidence: 98%

“…Comparison of the FE-1 test with the direct pancreatic function tests, the secretin-CCK or secretin-cerulein tests[23,[39][40][41][42][43][44] Patients with clinical symptoms of malassimilation ULN for FE-1: 200 lg/g stool…”

mentioning

confidence: 99%

Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test

et al. 2017

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“…Because the energy spectrum curves of different substances show differences, differences of the energy spectrum curves in different tissue sources, characteristics and components can be estimated, which enables the differential diagnosis. It can be inferred that the energy spectrum curve can be used to differentiate the origin of tumors, benign and malignant tumors, and tumors with different differentiation degrees, moreover, the energy spectrum curve can be quantitatively analyzed to provide new diagnostic ideas [14][15].…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Energy Spectrum Curves of Dual-energy CT in Evaluating Pathological Grading of Gastric Adenocarcinoma

Chen

et al. 2019

Preprint

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Backgroud: Accurate diagnosis of cancer staging and pathological differentiation are critical for the formulation of individualized treatment and prognosis of gastric cancer. It is vital to explore noninvasive preoperative imaging techniques to evaluate the pathological differentiation degree of gastric cancer tissues, and provide better diagnostic basis and decision-making reference for treatment. The purpose of this study was to explore the clinical value of energy spectrum curves of dual-source dual-energy CT in the quantitative evaluation of different pathological grades of gastric adenocarcinoma. Methods: A total of 62 patients with 1 well, 25 moderately and 36 poorly differentiated gastric adenocarcinomas pathologically confirmed by surgery were collected, and they underwent dual-source dual-energy CT plain scanning and enhanced scanning before operation. Dual-Energy software was used to measure the slope of the energy spectrum curves (λ) in arterial and venous phases after image reconstruction. Patients were divided into two groups according to the pathological results, including well and moderately differentiated gastric adenocarcinoma group and poorly differentiated gastric adenocarcinoma group. Data of each group were analyzed by independent sample t-test. The receiver operating characteristic curve was plotted to evaluate the diagnostic efficiency of the corresponding parameters. Results: There were significant differences in λ values of 40-50keV, 40-60keV, 40-80keV, 40-90keV, 40-100keV, 40-120keV, 40-130keV, 40-140keV and 40-150keV energy ranges in venous phase between the well and moderately differentiated group and poorly differentiated group (P<0.05), but no significant differences in λ values of different energy ranges in arterial phase between the two groups (P>0.05). And the area under curve in 40-120keV energy range was the largest in venous phase. K40-120keV =2.69 was selected as the diagnostic threshold with the maximum Youden index, the sensitivity and specificity were 61.1% and 76%, respectively. Conclusion: The energy spectrum curve of dual-energy CT had certain diagnostic value in the quantitative evaluation of pathological grading of gastric adenocarcinoma.

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“…performed a single-center study on 35 patients and showed that DECT is able to differentiate MFCP from PDAC through normalized iodine concentrations both on arterial and pancreatic parenchymal phases. [ 9 ] In addition, significant differences were observed in the value of the slope K of the spectrum curve. Regarding the assessment of PDAC after chemoradiotherapy, a preliminary study was performed by Kawamoto et al .…”

Section: Current Technical Innovationsmentioning

confidence: 99%

How new technologies could impact on radiology diagnosis and assessment of pancreatic lesions: Future perspectives

Laghi

Zerunian

2018

Endosc Ultrasound

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Pancreatic ductal adenocarcinoma and chronic mass-forming pancreatitis: Differentiation with dual-energy MDCT in spectral imaging mode

Abstract: Individual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching.

Cited by 61 publications

References 34 publications

Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test

Potential for Screening for Pancreatic Exocrine Insufficiency Using the Fecal Elastase-1 Test

Clinical Value of Energy Spectrum Curves of Dual-energy CT in Evaluating Pathological Grading of Gastric Adenocarcinoma

How new technologies could impact on radiology diagnosis and assessment of pancreatic lesions: Future perspectives

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