New advances in CT imaging of pancreas diseases: a narrative review

Abstract

Computed tomography (CT) plays a pivotal role as a diagnostic tool in many diagnostic and diffuse pancreatic diseases. One of the major limits of CT is related to the radiation exposure of young patients undergoing repeated examinations. Besides the standard CT protocol, the most recent technological advances, such as low-voltage acquisitions with high performance X-ray tubes and iterative reconstructions, allow for significant optimization of the protocol with dose reduction. The variety of CT tools are further expanded by the introduction of dual energy: the production of energy-selective images (i.e., virtual monochromatic images) improves the image contrast and lesion detection while the materialselective images (e.g., iodine maps or virtual unenhanced images) are valuable for lesion detection and dose reduction. The perfusion techniques provide diagnostic and prognostic information lesion and parenchymal vascularization and interstitium. Both dual energy and perfusion CT have the potential for pushing the limits of conventional CT from morphological evaluation to quantitative imaging applied to inflammatory and oncological diseases. Advances in post-processing of CT images, such as pancreatic volumetry, texture analysis and radiomics provide relevant information for pancreatic function but also for the diagnosis, management and prognosis of pancreatic neoplasms. Artificial intelligence is promising for optimization of the workflow in qualitative and quantitative analyses. Finally, basic concepts on the role of imaging on screening of pancreatic diseases will be provided.

Prognostic nomogram incorporating radiological features for predicting overall survival in patients with AIDS-related non-Hodgkin lymphoma

“…[8,10,12] CT of the head and neck, chest, abdomen, and pelvis is a critical staging modality recommended by the NCCN guidelines. [18][19][20] The potential mechanism of necrosis in lymphoma is the occlusion of the supplying hilar artery by the tumor (compression or invasion) in addition to lymphatic flow obstruction. [21,22] A previous study reported that HIV (À) NHL patients with necrosis had significantly higher Ann Arbor stages, greater IPI, and higher serum LDH levels than those without necrosis.…”

“…Imaging plays an important role in the detection and evaluation of AR-NHL lesions [8,10,12] . CT of the head and neck, chest, abdomen, and pelvis is a critical staging modality recommended by the NCCN guidelines [18–20] . The potential mechanism of necrosis in lymphoma is the occlusion of the supplying hilar artery by the tumor (compression or invasion) in addition to lymphatic flow obstruction [21,22] …”

“…Patients eligible for this study were (1) with age >18 years, (2) with a history of HIV-infection, (3) with pathologically confirmed diffuse large B-cell lymphoma (DLBCL) or Burkitt lymphoma (BL), [19] and (4) with available clinical and CT imaging data before any clinical intervention. Patients with Hodgkin lymphoma, indolent B-cell non-Hodgkin lymphoma (NHL), and T-cell NHL or lacking a specific pathological type were excluded.…”

Stability of computed tomography densitometry in patients with otosclerosis:a two-year follow-up

“…HRCT is usually necessary for preoperative evaluation before a stapes operation to ensure the surgeon is aware of any abnormalities which could interfere with the operation. HRCT imaging does not come without its drawbacks which include the cost and radiation exposure which can be especially detrimental for patients undergoing repeated examinations as is seen in patients with bilateral otosclerosis ( Agostini et al., 2020 ). As such, it would be beneficial to determine whether a patient with bilateral otosclerosis requires a repeated CT scan before the second stapes surgery or if the evaluation from the initial surgery is still representative.…”

Larger Volume and Higher Fat Content of the Pancreatic Head Are Predictive Factors for Postendoscopic Retrograde Cholangiopancreatography Pancreatitis

“…13 A more sophisticated evaluation involves histogram analysis to quantify the percentage of fat. 13 Hong et al 14 demonstrated that measurement of pancreatic fat content was a useful marker for predicting the formation of pancreatic fistula. Fujisawa et al 15 reported that obesity could be a risk factor for PEP and noted in their obesity group that an excess of subcutaneous adipose tissue might be an especially important factor related to PEP incidence.…”