Dual-energy perfusion-CT of pancreatic adenocarcinoma

Purpose: To 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 methods: 24 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 kV(p), 140 kV(p), and weighted average (linearly blended M0.3) 120 kV(p)-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. Results: In 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 kV(p)-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 kV(p) the standard deviations of the kV(p)120 kV(p)-equivalent values were manifestly smaller. Conclusion: Dual-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 kV(p). Therefore using dual-energy perfusion data could improve the delineation of pancreatic carcinomas. (C) 2012 Elsevier Ireland Ltd. All rights reserved.