Dual-energy perfusion-CT of pancreatic adenocarcinoma

PurposeTo evaluate the feasibility of dual-energy CT (DECT)-perfusion of pancreatic carcinomas for assessing the differences in perfusion, permeability and blood volume of healthy pancreatic tissue and histopathologically confirmed solid pancreatic carcinoma.Materials and methods24 patients with histologically proven pancreatic carcinoma were examined prospectively with a 64-slice dual source CT using a dynamic sequence of 34 dual-energy (DE) acquisitions every 1.5 s (80 ml of iodinated contrast material, 370 mg/ml, flow rate 5 ml/s). 80 kVp, 140 kVp, and weighted average (linearly blended M0.3) 120 kVp-equivalent dual-energy perfusion image data sets were evaluated with a body-perfusion CT tool (Body-PCT, Siemens Medical Solutions, Erlangen, Germany) for estimating perfusion, permeability, and blood volume values. Color-coded parameter maps were generated.ResultsIn all 24 patients dual-energy CT-perfusion was. All carcinomas could be identified in the color-coded perfusion maps. Calculated perfusion, permeability and blood volume values were significantly lower in pancreatic carcinomas compared to healthy pancreatic tissue. Weighted average 120 kVp-equivalent perfusion-, permeability- and blood volume-values determined from DE image data were 0.27 ± 0.04 min−1 vs. 0.91 ± 0.04 min−1 (p < 0.0001), 0.5 ± 0.07 *0.5 min−1 vs. 0.67 ± 0.05 *0.5 min−1 (p = 0.06) and 0.49 ± 0.07 min−1 vs. 1.28 ± 0.11 min−1 (p < 0.0001). Compared with 80 and 140 kVp the standard deviations of the kVp120 kVp-equivalent values were manifestly smaller.ConclusionDual-energy CT-perfusion of the pancreas is feasible. The use of DECT improves the accuracy of CT-perfusion of the pancreas by fully exploiting the advantages of enhanced iodine contrast at 80 kVp in combination with the noise reduction at 140 kVp. Therefore using dual-energy perfusion data could improve the delineation of pancreatic carcinomas.