Application of spectral CT combined with perfusion scan in diagnosis of pancreatic neuroendocrine tumors

Abstract

Background Pancreatic neuroendocrine tumors (pNETs) are heterogeneous tumors from the pancreatic neuroendocrine system, and early diagnosis is important for tumor prognosis and treatment. In this study, we aimed to explore the diagnostic value of spectral CT combined with perfusion scanning in improving the detection rate of pNETs. Methods From December 2018 to December 2020, 58 patients with clinically suspected pNETs were prospectively enrolled in the study for one-stop spectral CT combined with perfusion scanning, 36 patients were confirmed with pNETs by histopathology. An independent cohort of 30 patients with pNETs who underwent routine pancreatic perfusion scanning in our hospital during the same period were retrospectively collected. The image characters of pNETs versus tumor-free pancreatic parenchymal were examined. Results The detection rate of spectral CT combined with perfusion was 83.1–96.2%. CT values of the pNETs lesions under each single energy in the arterial phase were statistically higher than those of the adjacent normal pancreatic parenchyma. IC, WC and NIC, in the arterial phase of pNETs lesion were all statistically higher than those of the adjacent normal pancreatic parenchyma. The perfusion parameters of pNETs including BF, BV and MSI were significantly higher than those in normal parenchyma. The average effective radiation dose during the perfusion combined energy spectrum enhanced scanning process was 17.51 ± 2.18 mSv. Conclusion The one-stop spectral CT combined with perfusion scan improves the detection of pNETs according to morphological features, perfusion parameters and energy spectrum characters with a relatively small radiation dose.

Innovative imaging approaches for neuroendocrine tumor characterization: Combined dual energy CT and perfusion protocol implementation

“…Despite its utilities, the role of computed tomography perfusion has been found limited in clinical practice due to the need for standardizing protocols [ 15 ] and the high radiation dose it entails [ 12 ]. Hence, the combination of this technique with dual-energy computed tomography has been proposed as a viable alternative at the healthcare level, as it has proven useful in diagnosing neuroendocrine tumors while reducing radiation exposure by at least 10% compared to traditional computed tomography with classic perfusion protocol, among other advantages [ 6 ].…”

“…Though relatively underutilized, the combined employment of computed tomography with perfusion protocol and dual-energy computed tomography holds promise in accurately identifying such tumors [ 6 ]. This diagnostic imaging proves indispensable in characterizing, staging, and determining therapeutic courses of action [ 7 ].…”

Technical comparison of continuous versus intermittent perfusion computed tomography computed tomography scans of the human pancreas

“…Perfusion computed tomography (CT) imaging offers functional information about specific tissue or organs by continuously injecting a contrast medium into the vein. It is an increasingly attractive adjunct to conventional CT for neoplastic grading, predicting prognosis, and evaluating the response to therapy (1)(2)(3)(4). With the advancement of CT equipment and technology, pancreatic perfusion CT has been used to effectively differentiate pancreatic adenocarcinoma and neuroendocrine tumors (5), as well as to predict the development of pancreatic necrosis from early-stage acute pancreatitis (6,7).…”

Quantitative energy spectrum CT in differential diagnosis of aldosterone-producing adenoma and cortisol-producing adenoma

“…As an imaging technology, dual-energy computed tomography (DECT) or called spectrum CT has the advantages of providing multiple quantitative information for various materials inside the tissue ( 4 ), to clarify benign and malignant tumors ( 5 , 6 ). DECT can provide richer qualitative and quantitative diagnostic information by taking the advantage of covering a wider spectrum of energy parameters to reflect the state of blood supply and angiogenesis in a lesion directly and accurately.…”