One-Stop multienergy pancreatic dynamic volume perfusion imaging using photon-counting detector CT: Initial...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Pancreatic ductal adenocarcinoma (PDAC) diagnosis relies heavily on imaging.
• Current imaging techniques may have limitations in comprehensive morphologic and functional assessment.
• A novel multienergy VPCT protocol using photon-counting CT (PCCT) has been developed.

Purpose of the Study:

• To evaluate the initial experience with a modified one-stop, multienergy pancreatic VPCT protocol using PCCT.
• To assess its capability for comprehensive morphologic analysis and functional perfusion assessment of PDAC.
• To determine its effectiveness in differentiating PDAC and assessing histopathological grading.

Main Methods:

• Prospective enrollment of participants with suspected PDAC undergoing preoperative pancreatic dynamic VPCT.
• Extraction of individual phase images and virtual monoenergetic images (VMIs) at 55 and 70 keV.
• Quantitative and subjective assessment of diagnostic image quality.
• Generation and analysis of perfusion maps, comparing parameters between PDAC lesions and normal parenchyma, and among PDAC differentiation grades.
• Recording of radiation doses.

Main Results:

• The protocol included 65 participants with confirmed PDAC, achieving a mean effective radiation dose of 16.4 ± 4.5 mSv.
• 55 keV VMIs showed the highest contrast-to-noise ratio (CNR) and superior lesion conspicuity.
• Significant differences in perfusion parameters (BF, BV, TTD, etc.) were observed between PDAC lesions and normal parenchyma (p < 0.05).
• Poorly differentiated PDAC showed significantly lower BF, BV, TTD, and Tmax compared to well-differentiated lesions (p < 0.05).

Conclusions:

• The one-stop, multienergy pancreatic VPCT protocol using PCCT enables high-quality morphologic imaging and reliable functional perfusion assessment.
• The protocol achieves reduced radiation doses while providing valuable insights into PDAC differentiation and histopathological grading.
• This approach holds potential for improved clinical management of PDAC.