Laukamp, Kai Roman ORCID: 0000-0002-5600-5914, Tirumani, Sree Harsha, Lennartz, Simon, Hokamp, Nils Grosse, Gupta, Amit, Pennig, Lenhard, Persigehl, Thorsten, Gilkeson, Robert and Ramaiya, Nikhil . Evaluation of equivocal small cystic pancreatic lesions with spectral-detector computed tomography. Acta Radiol.. LONDON: SAGE PUBLICATIONS LTD. ISSN 1600-0455

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Abstract

Background Evaluation of small cystic lesions of the pancreas remains a challenging task, as due to their size appearance can be rather hypodense than clearly fluid-filled. Purpose To evaluate whether additional information provided by novel dual-layer spectral-detector computed tomography (SDCT) imaging can improve assessment of these lesions. Material and Methods For this retrospective study, we reviewed reports of 1192 contrast-enhanced portal-venous phase SDCT scans of the abdomen conducted between May 2017 and January 2019. On basis of the radiological report 25 small (<= 1.5 cm) cystic pancreatic lesions in 22 patients were identified, in which additional short-term follow-up imaging was recommended to confirm/clarify cystic nature. Conventional images (CI) and spectral images (SI) including virtual-monoenergetic images at 40 keV (VMI), iodine-density and iodine-overlay images were reconstructed. Two readers indicated lesion conspicuity and confidence for presence of cystic nature on three-point scales. First, solely CI were evaluated, while in a second reading after a four-week interval, the combination of CI and corresponding SI were reviewed. Quantitatively, ROI-based mean attenuation was measured in CI and VMI. Results In the subjective reading, SI significantly improved lesion conspicuity (CI 2 [1-2], SI 3 [2-3], P < 0.001) and confidence regarding presence of cystic nature (CI 2 [1-2], SI 3 [3-3], P < 0.001). Inter-observer agreement depicted by intraclass correlation coefficient improved considerably from 0.51 with only CI to 0.85 when the combination with SI was used. Further, VMI displayed significantly higher signal-to-noise (CI 1.2 +/- 0.8, VMI 3.2 +/- 1.8, P < 0.001) and contrast-to-noise ratios (CI 2.6 +/- 0.8, VMI 4.7 +/- 1.9). Conclusion Compared to CI alone, combination with SI significantly improves visualization and confidence in evaluation of small equivocal cystic pancreatic lesions.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Laukamp, Kai RomanUNSPECIFIEDorcid.org/0000-0002-5600-5914UNSPECIFIED
Tirumani, Sree HarshaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lennartz, SimonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hokamp, Nils GrosseUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gupta, AmitUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pennig, LenhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Persigehl, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gilkeson, RobertUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ramaiya, NikhilUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-336803
DOI: 10.1177/0284185120917119
Journal or Publication Title: Acta Radiol.
Publisher: SAGE PUBLICATIONS LTD
Place of Publication: LONDON
ISSN: 1600-0455
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ENERGY MULTIDETECTOR CT; DUAL-SOURCE; NEOPLASMS; ADENOCARCINOMA; PREVALENCE; DIAGNOSIS; USMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33680

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