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Multidetector CT of pancreatic ductal adenocarcinoma: Effect of tube voltage and iodine load on tumour conspicuity and image quality
Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; Ersta Hosp, Dept Radiol, S-11691 Stockholm, Sweden.
Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
Karolinska Inst, Dept Clin Sci Intervent & Technol CLINTEC, Div Med Imaging & Technol, S-14186 Stockholm, Sweden; C1 46 Karolinska Univ Hosp Huddinge, Dept Radiol, S-14186 Stockholm, Sweden.
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2016 (English)In: European Radiology, ISSN 0938-7994, E-ISSN 1432-1084, Vol. 26, no 11, 4021-4029 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To compare a low-tube-voltage with or without high-iodine-load multidetector CT (MDCT) protocol with a normal-tube-voltage, normal-iodine-load (standard) protocol in patients with pancreatic ductal adenocarcinoma (PDAC) with respect to tumour conspicuity and image quality.

METHODS: Thirty consecutive patients (mean age: 66 years, men/women: 14/16) preoperatively underwent triple-phase 64-channel MDCT examinations twice according to: (i) 120-kV standard protocol (PS; 0.75 g iodine (I)/kg body weight, n = 30) and (ii) 80-kV protocol A (PA; 0.75 g I/kg, n = 14) or protocol B (PB; 1 g I/kg, n = 16). Two independent readers evaluated tumour delineation and image quality blindly for all protocols. A third reader estimated the pancreas-to-tumour contrast-to-noise ratio (CNR). Statistical analysis was performed with the Chi-square test.

RESULTS: Tumour delineation was significantly better in PB and PA compared with PS (P = 0.02). The evaluation of image quality was similar for the three protocols (all, P > 0.05). The highest CNR was observed with PB and was significantly better compared to PA (P = 0.02) and PS (P = 0.0002).

CONCLUSION: In patients with PDAC, a low-tube-voltage, high-iodine-load protocol improves tumour delineation and CNR leading to higher tumour conspicuity compared to standard protocol MDCT.

KEY POINTS: • Low-tube-voltage high-iodine-load MDCT improves pancreatic cancer conspicuity compared to a standard protocol. • The pancreas-to-tumour attenuation difference increases significantly by reducing the tube voltage. • The radiation exposure dose decreases by reducing the tube voltage.

Place, publisher, year, edition, pages
2016. Vol. 26, no 11, 4021-4029 p.
Keyword [en]
Pancreatic neoplasm; Image enhancement; Contrast media; Multidetector computed tomography; Radiation dosage
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
URN: urn:nbn:se:uu:diva-305771DOI: 10.1007/s00330-016-4273-yISI: 000385248600027PubMedID: 26965503OAI: oai:DiVA.org:uu-305771DiVA: diva2:1039131
Available from: 2016-10-21 Created: 2016-10-21 Last updated: 2016-11-21Bibliographically approved

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