Investigating the value of dual-layer spectral detector CT in distinguishing resectable pancreatic ductal adenocarcinoma from mass-forming chronic pancreatitis
10.19401/j.cnki.1007-3639.2024.01.003
- VernacularTitle:探究双层光谱探测器CT在鉴别可切除胰腺导管腺癌与肿块型慢性胰腺炎方面的价值
- Author:
Wei LIU
1
;
Tiansong XIE
;
Lei CHEN
;
Zehua ZHANG
;
Zhengrong ZHOU
Author Information
1. 复旦大学附属肿瘤医院放射诊断科,复旦大学上海医学院肿瘤学系,上海 200032
- Keywords:
Pancreatic ductal adenocarcinoma;
Mass-forming chronic pancreatitis;
Dual-layer spectral detector computed tomography;
Conventional computed tomography
- From:
China Oncology
2024;34(1):67-73
- CountryChina
- Language:Chinese
-
Abstract:
Background and Purpose:Accurate differentiation of pancreatic ductal adenocarcinoma(PDAC)from mass-forming chronic pancreatitis(MFCP)is clinically significant.The application of dual-layer spectral detector CT(DLCT)in pancreas has been explored.This study aimed to investigate the value of DLCT in distinguishing resectable PDAC from MFCP.Methods:We retrospectively collected data of 33 patients with resectable PDAC and 19 patients with MFCP admitted to Fudan University Shanghai Cancer Center from September 1,2021 to May 31,2023.Prior to surgery,patients underwent enhanced DLCT scans,including arterial phase(AP),parenchymal phase(PP)and venous phase(VP).DLCT quantitative parameters,including attenuation enhancement fraction(AEF),lesion-to-parenchyma ratio(LPR)and iodine enhancement fraction(IEF)were calculated.Difference analysis was conducted using independent sample t-test or chi-square test.Univariate and multivariate analyses were performed using binary logistic regression.Receiver operating characteristic(ROC)curves were used for performance evaluation.P＜0.05 was considered statistically significant.Results:Statistically significant differences were observed between PDAC and MFCP in AEF_AP/PP,LPR40_VP,IEF_PP/VP,carbohydrate antigen 19-9(CA19-9)and double-duct sign(all P＜0.05).The spectral combined model composed of LPR40_VP and IEF_PP/VP exhibited the best discriminatory efficacy,surpassing CA19-9,double-duct sign and AEF_AP/PP(all P＜0.05).The combined model demonstrated an area under curve(AUC)of 0.841,sensitivity of 90%,specificity of 73%,and accuracy of 79%.Conclusion:DLCT has certain potential in differentiating resectable PDAC from MFCP.Spectral quantitative parameters can complement CA19-9 and outcome shortcomings of conventional CT in distinguishing resectable PDAC from MFCP.
