ISSN 1004-4140
CN 11-3017/P
| Citation: |
HUANG X Y, LI X M, GUO F K, et al. Combining Low-dose Perfusion with Dual-energy CT Scanning for Pancreatic Neuroendocrine Tumors[J]. CT Theory and Applications, 2025, 34(3): 369-375. DOI: 10.15953/j.ctta.2024.348. (in Chinese).
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Objectives: This study explores the clinical value of one-time, low-dose pancreatic CT perfusion combined with dual-energy scanning for detecting pancreatic neuroendocrine tumors. Methods: We retrospectively analyzed data from 23 patients with surgically or pathologically confirmed pancreatic neuroendocrine tumors who underwent pancreatic CT perfusion and delayed dual-energy CT scanning at our hospital between January 2020 to June 2024. The perfusion scan was performed at 80 kV and 40 kmAs, with 28 scans acquired at 1.5 ks intervals over a total duration of 42.42 ks. The dual-energy CT scan used a tube voltage of 100/Sn at 150 kV and a reference tube current of 180/90 kmAs. The radiation dose was recorded, the image quality of perfusion and dual-energy CT scans was subjectively assessed. The interobserver agreement was evaluated using the Kappa coefficient. Differences in blood flow (BF), blood volume (BV), mean transit time (MTT), flow-extraction product (FE), and time-density curve (TDC) characteristics between tumor lesions and normal pancreatic parenchyma were analyzed using the T-test. The diagnostic accuracy was assessed against surgical and pathological findings. Results: The image quality of both low-dose pancreatic perfusion and delayed dual-energy CT images met the diagnostic criteria, with high interobserver agreement (Kappa=0.79). The total effective radiation dose of the combined scan was (6.48±0.84) mSv. Compared to normal pancreatic parenchyma, the BF and BV in the abnormal perfusion areas of the lesions were significantly higher, whereas the MTT and peak TDC in lesion areas were slightly but significantly lower. The diagnostic accuracy of the single perfusion CT was 70.37% (19/27), whereas the combined one-time perfusion and delayed dual-energy CT achieved an accuracy of 85.18% (23/27), as confirmed in the 27 tumor lesions by the surgical and pathological results. Conclusions: One-time pancreatic perfusion CT combined with dual-energy CT scanning improves the diagnostic accuracy of pancreatic neuroendocrine tumors by enhancing morphological and perfusion parameter analysis while maintaining a low effective radiation dose. This approach has significant clinical value.
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