Dual-energy CT of the pancreas: comparison between virtual non-contrast images and true non-contrast images in the detection of pancreatic lesion

Purpose To evaluate the image quality and diagnostic performance for pancreatic lesion between true non-contrast (TNC) and virtual non-contrast (VNC) images obtained from the dual-energy computed tomography (DECT). Methods One hundred six patients with pancreatic mass underwent contrast-enhanced DEC...

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Bibliographic Details
Published in:Abdominal imaging 2023-08, Vol.48 (8), p.2596-2603
Main Authors: Liang, Hongwei, Du, Silin, Yan, Gaowu, Zhou, Yang, Yang, Tianyu, Zhang, Zhiwei, Luo, Chenyi, Liao, Hongfan, Li, Yongmei
Format: Article
Language:English
Subjects:
Abdomen
Attenuation
Computed tomography
Diagnostic systems
Gastroenterology
Hepatology
Humans
Image contrast
Image enhancement
Image quality
Image reconstruction
Imaging
Lesions
Medical imaging
Medicine
Medicine & Public Health
Pancreas
Pancreas - diagnostic imaging
Pancreatic Neoplasms - diagnostic imaging
Quality assessment
Radiation
Radiation effects
Radiology
Reduction
Reproducibility
Reproducibility of Results
Retrospective Studies
Tomography, X-Ray Computed - methods
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Summary:Purpose To evaluate the image quality and diagnostic performance for pancreatic lesion between true non-contrast (TNC) and virtual non-contrast (VNC) images obtained from the dual-energy computed tomography (DECT). Methods One hundred six patients with pancreatic mass underwent contrast-enhanced DECT examinations were retrospectively included in this study. VNC images of the abdomen were generated from late arterial (aVNC) and portal (pVNC) phases. For quantitative analysis, the attenuation differences and reproducibility of abdominal organs were compared between TNC and aVNC/pVNC measurements. Qualitatively image quality was assessed by two radiologists using a five-point scale, and they independently compared the detection accuracy of pancreatic lesions between TNC and aVNC/pVNC images. The volume CT dose index (CTDIvol) and size-specific dose estimates (SSDE) were recorded to evaluate the potential dose reduction when using VNC reconstruction to replace the unenhanced phase. Results A total of 78.38% (765/976) of the attenuation measurement pairs were reproducible between TNC and aVNC images, and 71.0% (693/976) between TNC and pVNC images. In triphasic examinations, a total of 108 pancreatic lesions were found in 106 patients, and no significant difference in detection accuracy was found between TNC and VNC images ( p  = 0.587–0.957). Qualitatively, image quality was rated diagnostic (score ≥ 3) in all the VNC images. Calculated CTDIvol and SSDE reduction of about 34% could be achieved by omitting the non-contrast phase. Conclusion VNC images of DECT provide diagnostic image quality and accurate pancreatic lesions detection, which are a promising alternative to unenhanced phase with a substantial reduction of radiation exposure in clinical routine.
ISSN:2366-0058
2366-004X
2366-0058
DOI:10.1007/s00261-023-03914-0