Pancreatic cancer in photon-counting CT: Low keV virtual monoenergetic images improve tumor conspicuity

• Published in: European journal of radiology 2024-04, Vol.173, p.111374-111374, Article 111374
• Main Authors: Woeltjen, Matthias Michael, Niehoff, Julius Henning, Roggel, Ruth, Michael, Arwed Elias, Gerdes, Berthold, Surov, Alexey, Borggrefe, Jan, Kroeger, Jan Robert
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - diagnostic imaging; Humans; Pancreatic adenocarcinoma; Pancreatic Neoplasms - diagnostic imaging; PCCT; Radiographic Image Interpretation, Computer-Assisted; Radiography, Dual-Energy Scanned Projection - methods; Retrospective Studies; Signal-To-Noise Ratio; Tomography, X-Ray Computed - methods; Tumor conspicuity; Virtual monoenergetic images
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2024.111374

The aim of the study was to identify differences in the tumor conspicuity of pancreatic adenocarcinomas in different monoenergetic or polyenergetic reconstructions and contrast phases in photon-counting CT (PCCT). 34 patients were retrospectively enrolled in this study. Quantitative image analysis was performed with region of interest (ROI) measurements in different monoenergetic levels ranging from 40 up to 70 keV (5-point steps) and polyenergetic series. Tumor-parenchyma attenuation differences and contrast-to-noise-ratio (CNR) were calculated. A qualitative image analysis was accomplished by 4 radiologists using a 5-point Likert scale (1 = “not recognizable” up to 5 = “easy recognizable”). Differences between groups were evaluated for statistical significance using the Friedman test and in case of significant differences pair-wise post-hoc testing with Bonferroni correction was applied. Tumor-parenchyma attenuation difference was significantly different between the different image reconstructions for both arterial- and portal-venous-phase-images (p