記述言語：日本語   出版者・発行元：Tomography  

Objectives: The potential use of electron density (ED) and effective atomic number (Zeff) derived from dual-energy computed tomography (DECT) as novel quantitative imaging biomarkers for differentiating malignant brain tumors was investigated. Methods: Data pertaining to 136 patients with a pathological diagnosis of brain metastasis (BM), glioblastoma, and primary central nervous system lymphoma (PCNSL) were retrospectively reviewed. The 10th percentile, mean and 90th percentile values of conventional 120-kVp CT value (CTconv), ED, Zeff, and relative apparent diffusion coefficient derived from diffusion-weighted magnetic resonance imaging (rADC: ADC of lesion divided by ADC of normal-appearing white matter) within the contrast-enhanced tumor region were compared across the three groups. Furthermore, machine learning (ML)-based diagnostic models were developed to maximize diagnostic performance for each tumor classification using the indices of DECT parameters and rADC. Machine learning models were developed using the AutoGluon-Tabular framework with rigorous patient-level data splitting into training (60%), validation (20%), and independent test sets (20%). Results: The 10th percentile of Zeff was significantly higher in glioblastomas than in BMs (p = 0.02), and it was the only index with a significant difference between BMs and glioblastomas. In the comparisons including PCNSLs, all indices of CTconv, Zeff, and rADC exhibited significant differences (p < 0.001–0.02). DECT-based ML models exhibited high area under the receiver operating characteristic curves (AUC) for all pairwise differentiations (BMs vs. Glioblastomas: AUC = 0.83; BMs vs. PCNSLs: AUC = 0.91; Glioblastomas vs. PCNSLs: AUC = 0.82). Combined models of DECT and rADC demonstrated excellent diagnostic performance between BMs and PCNSLs (AUC = 1) and between Glioblastomas and PCNSLs (AUC = 0.93). Conclusion: This study suggested the potential of DECT-derived ED and Zeff as novel quantitative imaging biomarkers for differentiating malignant brain tumors.

DOI： 10.3390/tomography11110120

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PubMed

記述言語：日本語   出版者・発行元：Tomography  

Objectives: Few studies have reported in vivo measurements of electron density (ED) and effective atomic number (Z<inf>eff</inf>) in normal brain tissue. To address this gap, dual-energy computed tomography (DECT)-derived ED and Z<inf>eff</inf> maps were used to characterize normal-appearing adult brain tissues, evaluate age-related changes, and investigate correlations with myelin partial volume (V<inf>my</inf>) from synthetic magnetic resonance imaging (MRI). Materials and Methods: Thirty patients were retrospectively analyzed. The conventional computed tomography (CT) value (CT<inf>conv</inf>), ED, Z<inf>eff</inf>, and V<inf>my</inf> were measured in the normal-appearing gray matter (GM) and white matter (WM) regions of interest. V<inf>my</inf> and DECT-derived parameters were compared between WM and GM. Correlations between V<inf>my</inf> and DECT parameters and between age and DECT parameters were analyzed. Results: V<inf>my</inf> was significantly greater in WM than in GM, whereas CT<inf>conv</inf>, ED, and Z<inf>eff</inf> were significantly lower in WM than in GM (all p < 0.001). Z<inf>eff</inf> exhibited a stronger negative correlation with V<inf>my</inf> (ρ = −0.756) than CT<inf>conv</inf> (ρ = −0.705) or ED (ρ = −0.491). ED exhibited weak to moderate negative correlations with age in nine of the 14 regions. In contrast, Z<inf>eff</inf> exhibited weak to moderate positive correlations with age in nine of the 14 regions. CT<inf>conv</inf> exhibited negligible to insignificant correlations with age: Conclusions: This study revealed distinct GM–WM differences in ED and Z<inf>eff</inf> along with opposing age-related changes in these quantities. Therefore, myelin may have substantially contributed to the lower Z<inf>eff</inf> observed in WM, which underlies the GM–WM contrast observed on non-contrast-enhanced CT.

DOI： 10.3390/tomography11090095

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PubMed

記述言語：日本語   出版者・発行元：Medicina Lithuania  

Background and Objectives: The causes and clinical outcomes of renal perfusion abnormalities occurring after para-aortic lymphadenectomy (PANDx) for gynecologic malignancies are unknown. We investigated the potential involvement of accessory renal artery (ARA) obstruction in their development by reassessing perioperative contrast-enhanced computed tomography (CECT). Materials and Methods: This retrospective study investigated a clinical database to identify urinary contrast defects using CECT in all patients who had undergone PANDx between January 2020 and December 2024. The perfusion defects in the kidney detected by CECT were extracted by a gynecologic oncologist and evaluated by a radiologist and urologist for suspected obstruction of ARAs. Results: Postoperative renal contrast defects were observed in 3.8% (6/157) of patients. Renal parenchymal fibrosis, cortical atrophy, and parenchymal thinning were observed as universal findings in all patients showing renal contrast defects. In five of the six cases, ARAs supplying the infarcted renal segments were identified on preoperative CECT, and arterial obstruction was confirmed on postoperative imaging. The remaining case was considered to be latent pyelonephritis. All five patients underwent laparotomy, and preoperative CECT failed to detect ARAs. The median resected para-aortic lymph node was 23 nodes (range: 15–33) in five patients, showing no statistically significant difference compared to patients without perfusion abnormalities (p = 0.19). Postoperative serum creatinine levels remained stable. Conclusions: ARA obstruction appears to be a risk factor for segmental renal infarction after para-aortic lymphadenectomy in gynecological malignancies; however, the clinical impact on urinary function may be limited. Awareness of this potential complication is essential for gynecologic oncologists performing PANDx.

DOI： 10.3390/medicina61081395

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PubMed

記述言語：英語   出版者・発行元：John Wiley & Sons Australia, Ltd  

婦人科癌に対する傍大動脈リンパ節郭清術(PANDx)の手術転帰の改善における術前三次元CT(3DCT)の有用性について検討した。2023年1月～2024年11月にPANDxを施行した婦人科癌患者72例を非3DCT群(造影CTを実施、38例)と3DCT群(34例)へ分類した。3DCT群では14例(41.2%)に腎血管バリエーション、2例(5.9%)に重複尿管を認めたのに対し、非3DCT群では解剖学的異常は認めなかった。術後合併症は非3DCT群でやや高率であり、lymphocyte infection、乳び漏、腸閉塞を認めた。術後CTにおける造影効果の均一性について検討した結果、最も複雑な尿路血管バリエーションを有する3DCT群の1例で右腎下極に造影効果の低下を認めた。また、3DCT群の8例(23.5%)では一側または両側腎動脈が腎静脈下端の尾側に位置していた。婦人科癌において、PANDx施行前の3DCTは従来の造影CTに比較して尿路血管バリエーションの同定に優れていると考えられた。

記述言語：日本語   出版者・発行元：Journal of Obstetrics and Gynaecology Research  

Background: The evaluation of anatomical abnormalities involving urinary vessel variations prior to para-aortic lymphadenectomy in gynecological malignancies is challenging. In this context, the utility of preoperative three-dimensional (3D) computed tomography (3DCT) angiography in improving surgical outcomes was examined. Methods: This retrospective study evaluated the utility of 3DCT in patients who underwent para-aortic lymphadenectomy between January 2023 and November 2024. 3D fusion images were constructed from the arterial phase, CT-venography, and CT-urography. A total of 72 patients were included and divided into two groups: non-3DCT and 3DCT. Outcomes included detection rates of arterial, venous, or urinary tract variations and surgical outcomes, including complications, in both groups. Results: The 3DCT group included 14/34 (41.2%) cases with renal vessel variations and two cases (5.9%) with double ureters; the non-3DCT group did not detect any anatomical abnormalities. In the 3DCT group, renal vessel and urinary tract variations were clearly shown. Postoperative complications tended to be slightly higher in the non-3DCT group, including lymphocyte infection, chylous leakage, and bowel obstruction. Postoperative CT revealed reduced contrast in the lower pole of the right kidney in the 3DCT case with the most complex urinary vessel variations. Furthermore, in the 3DCT group, 8/34 (23.5%) unilateral or bilateral renal arteries were located caudally to the lower edge of the renal vein. Conclusion: In gynecological malignancies, 3DCT before para-aortic lymphadenectomy seems superior in identifying urinary vessel variations over conventional contrast-enhanced CT; thus, aiding realistic preoperative simulations and potentially reducing surgeons' burden and perioperative complications.

DOI： 10.1111/jog.16367

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PubMed

記述言語：英語   出版者・発行元：(公社)日本医学放射線学会  

当院で治療前にデュアルエナジーCT(DECT)検査を受けた肺血栓塞栓症(PE)患者30例が有する血栓49個に対し、造影CT(CECT)で診断したPEを参照標準として、DECT画像分析前にCECT上で血栓位置のアノテーションを行った。治療前肺血栓を撮像した120kVp画像、40keVおよび70keV画像により、仮想単色X線(VM)画像からCT減衰値と実効原子番号および電子密度(ED)を単純CT画像から測定した。また、治療後の経過観察CT画像により血栓を溶解群と残存群に分け、群間でDECTパラメータを比較した。その結果、溶解群血栓のED値、120kVp画像上および70keV VM画像上のCT減衰値は残存群に比べ有意に高く、ED、120kVp画像および70keV VM画像による治療効果予測に対するAUCは0.856、0.744および0.755で、EDのAUCは他2つに比べ有意に高かったことからも、単純DECTによるEDは、PE患者の治療効果予測に役立つと考えられた。

記述言語：日本語   出版者・発行元：Japanese Journal of Radiology  

Purpose: To clarify the usefulness of electron density (ED) using dual-energy CT (DECT) parameters for predicting treatment response in patients with pulmonary embolism (PE). Materials and methods: The study population comprised 30 patients with PE (49 thrombi) who underwent pretreatment DECT. The study coordinator diagnosed PE using contrast-enhanced CT (CECT) as the gold standard and annotated the location of thrombi on CECT prior to the DECT image analyses. CT attenuation values on conventional 120 kVp, 40 keV, and 70 keV virtual monochromatic (VM) images; effective atomic number; and ED of pretreatment pulmonary thrombi were measured on unenhanced CT. Thrombi were classified into dissolved and residual groups according to the findings of posttreatment follow-up CT. DECT parameters were compared between the two groups using the Mann–Whitney U test. For statistically significant parameters, receiver-operating characteristic (ROC) analysis was used to evaluate their performance for differentiating two groups. Diagnostic accuracy for predicting treatment response in patients with PE was determined by calculating the area under the ROC curve (AUC). Results: ED values, CT values on conventional 120 kVp imaging, and those on 70 keV VM imaging were significantly higher in thrombi in the dissolved group than the residual group (p < 0.001, p = 0.012, p = 0.009, respectively). AUC values for predicting dissolution response by ED, conventional 120 kVp imaging, and 70 keV VM imaging (cut-off value, 3.49 × 10²³/cm³, 53.4 HU, and 50.7 HU, respectively) were 0.856, 0.744, and 0.755, respectively. AUC was significantly higher for ED than for conventional 120 kVp imaging and 70 keV VM imaging (p = 0.032, p = 0.016). Conclusions: ED derived from unenhanced DECT may help predict therapeutic efficacy in patients with PE.

DOI： 10.1007/s11604-025-01747-z

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PubMed

記述言語：日本語   出版者・発行元：(公社)日本医学放射線学会  

記述言語：日本語   出版者・発行元：Journal of Neuroimaging  

Background and Purpose: Differentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of using time-dependent diffusion MRI (dMRI) for microstructural characterization of PAs. Methods: The study included 54 participants, 24 with functioning PA and 30 with nonfunctioning PA. Time-dependent dMRI of the pituitary gland was performed using an inner field-of-view echo-planar imaging based on 2-dimensional-selective radiofrequency excitations with oscillating gradient and pulsed gradient preparation (effective diffusion time: 7.1 and 36.3 ms) at b-values of 0 and 1000 seconds/mm². Each tumor had its apparent diffusion coefficients (ADCs) measured at two diffusion times (ADC<inf>7.1 ms</inf> and ADC<inf>36.3 ms</inf>), its ADC change (cADC), and relative ADC change. The mean values of diffusion parameters were compared between functioning and nonfunctioning PAs. We compared the diffusion parameters of nonfunctioning PAs with those of each type of hormone-producing PAs. The diagnostic performances of the diffusion parameters were assessed. Results: The cADC was significantly higher in functioning PAs than nonfunctioning PAs (p =.0124). The receiver operating characteristic (ROC) curve analysis revealed that cADC (area under the ROC curve [AUC] =.677, p =.017) is effective in distinguishing between functioning and nonfunctioning PAs. The cADC was significantly higher in growth hormone (GH)-producing PAs compared to nonfunctioning PAs (p =.006). The ROC curve analysis indicated that cADC (AUC =.771, p <.001) effectively distinguishes between GH-producing and nonfunctioning PAs. Conclusions: The cADC derived from time-dependent dMRI could distinguish between functioning and nonfunctioning PAs, particularly those producing GH.

DOI： 10.1111/jon.13254

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PubMed

記述言語：英語   出版者・発行元：(一社)日本磁気共鳴医学会  

記述言語：英語   出版者・発行元：日本磁気共鳴医学会  

Purpose: This study aimed to evaluate the feasibility of single-shot echo planar diffusion-weighted imaging with compressed SENSE (EPICS-DWI) for pancreas assessment by comparing with single-shot echo planar DWI with parallel imaging (PI-DWI). Methods: This multicenter prospective study included 27 consecutive participants with untreated pancreatic ductal adenocarcinoma (PDAC) (15 men; mean age, 67 ± 10 years) who underwent pancreatic protocol MRI including both PI-DWI and EPICS-DWI. Two radiologists independently and randomly reviewed the high b-value DWI images and qualitatively assigned confidence scores for overall image quality, image noise, pancreas conspicuity, and PDAC conspicuity using a 5-point scale. One radiologist measured the PDAC-to-pancreas contrast-to-noise-ratio (CNR) on high b-value DWI images and the apparent diffusion coefficient (ADC) value of PDAC. Qualitative and quantitative parameters were compared between PI-DWI and EPICS-DWI using the Wilcoxon signed-rank test. Results: The confidence scores for overall image quality (P < 0.001 in both radiologists) and image noise (P < 0.001 in both radiologists) were higher in EPICS-DWI than in PI-DWI. The pancreas conspicuity was better in EPICS-DWI than in PI-DWI in one of the radiologists (P = 0.02 and 0.06). The PDAC conspicuity was comparable between PI-DWI and EPICS-DWI (P > 0.99 in both radiologists). The PDAC-to-pancreas CNR was higher in EPICS-DWI than in PI-DWI (P = 0.02), while the ADC value of PDAC in PI-DWI was not significantly different compared to that in EPICS-DWI (P = 0.48). Conclusion: The image quality and PDAC-to-pancreas CNR was improved in EPICS-DWI compared to PI-DWI. However, the conspicuity and ADC value of PDAC were comparable between PI-DWI and EPICS-DWI.

DOI： 10.2463/mrms.mp.2024-0046

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CiNii Research

記述言語：日本語   出版者・発行元：Journal of Magnetic Resonance Imaging  

Background: Oscillating gradient diffusion-weighted imaging (DWI) enables elucidation of microstructural characteristics in cancers; however, there are limited data to evaluate its utility in patients with endometrial cancer. Purpose: To investigate the utility of oscillating gradient DWI for risk stratification in patients with uterine endometrial cancer compared with conventional pulsed gradient DWI. Study Type: Retrospective. Subjects: Sixty-three women (mean age: 58 [range: 32–85] years) with endometrial cancer. Field Strength/Sequence: 3 T MRI including DWI using oscillating gradient spin-echo (OGSE) and pulsed gradient spin-echo (PGSE) research sequences. Assessment: Mean value of the apparent diffusion coefficient (ADC) values for OGSE (ADC<inf>OGSE</inf>) and PGSE (ADC<inf>PGSE</inf>) as well as the ADC ratio (ADC<inf>OGSE</inf>/ADC<inf>PGSE</inf>) within endometrial cancer were measured using regions of interest. Prognostic factors (histological grade, deep myometrial invasion, lymphovascular invasion, International Federation of Gynecology and Obstetrics [FIGO] stage, and prognostic risk classification) were tabulated. Statistical Tests: Interobserver agreement was analyzed by calculating the intraclass correlation coefficient. The associations of ADC<inf>OGSE</inf>, ADC<inf>PGSE</inf>, and ADC<inf>OGSE</inf>/ADC<inf>PGSE</inf> with prognostic factors were examined using the Kendall rank correlation coefficient, Mann–Whitney U test, and receiver operating characteristic (ROC) curve. A P value of <0.05 was statistically significant. Results: Compared with ADC<inf>OGSE</inf> and ADC<inf>PGSE</inf>, ADC<inf>OGSE</inf>/ADC<inf>PGSE</inf> was significantly and strongly correlated with histological grade (observer 1, τ = 0.563; observer 2, τ = 0.456), FIGO stage (observer 1, τ = 0.354; observer 2, τ = 0.324), and prognostic risk classification (observer 1, τ = 0.456; observer 2, τ = 0.385). The area under the ROC curves of ADC<inf>OGSE</inf>/ADC<inf>PGSE</inf> for histological grade (observer 1, 0.92, 95% confidence intervals [CIs]: 0.83–0.98; observer 2, 0.84, 95% CI: 0.73–0.92) and prognostic risk (observer 1, 0.80, 95% CI: 0.68–0.89; observer 2, 0.76, 95% CI: 0.63–0.86) were significantly higher than that of ADC<inf>OGSE</inf> and ADC<inf>PGSE</inf>. Data Conclusion: The ADC ratio obtained via oscillating gradient and pulsed gradient DWIs might be useful imaging biomarkers for risk stratification in patients with endometrial cancer. Level of Evidence: 3. Technical Efficacy: Stage 2.

DOI： 10.1002/jmri.29106

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PubMed

記述言語：日本語   出版者・発行元：(公社)日本医学放射線学会  

出版者・発行元：金原出版  

DOI： 10.18888/rp.0000002552

CiNii Research

記述言語：日本語   出版者・発行元：金原出版(株)  

＜文献概要＞後腹膜は,臓側腹膜背面から背部の腹横筋膜までの潜在的空間で,頭尾側は横隔膜下腹膜外腔～骨盤腹膜外腔と連続している。また,腎筋膜により,前腎傍腔(膵,上行・下行結腸,十二指腸下行部～上行部),腎周囲腔(腎,近位尿管,副腎,精巣・卵巣動静脈)および後腎傍腔の3つのコンポーネントに分けられる。副腎は腎周囲腔内で腎臓の内側上方に位置する一対の内分泌器官である。右副腎はピラミッド状,左副腎は半月状の形態を呈し,断層画像の横断像では"人"の字型に描出され,中心の体部と左右に分かれた厚み5mm未満の内・外側脚を認める。一方,後腹膜腔には,副腎,腎・尿管,膵,消化管などの臓器以外に血管,リンパ管,リンパ節,神経,線維組織や脂肪などの結合織があり,様々な腫瘍が発生する。副腎と後腹膜腫瘍いずれにおいても,良性と悪性腫瘍に大別されるが,それぞれの疾患の画像的特徴や注意点を熟知することが重要である。

記述言語：日本語   出版者・発行元：Cancer Imaging  

Background: This study aimed to elucidate the impact of effective diffusion time setting on apparent diffusion coefficient (ADC)-based differentiation between primary central nervous system lymphomas (PCNSLs) and glioblastomas (GBMs) and to investigate the usage of time-dependent diffusion magnetic resonance imaging (MRI) parameters. Methods: A retrospective study was conducted involving 21 patients with PCNSLs and 66 patients with GBMs using diffusion weighted imaging (DWI) sequences with oscillating gradient spin-echo (Δ<inf>eff</inf> = 7.1 ms) and conventional pulsed gradient (Δ<inf>eff</inf> = 44.5 ms). In addition to ADC maps at the two diffusion times (ADC<inf>7.1 ms</inf> and ADC<inf>44.5 ms</inf>), we generated maps of the ADC changes (cADC) and the relative ADC changes (rcADC) between the two diffusion times. Regions of interest were placed on enhancing regions and non-enhancing peritumoral regions. The mean and the fifth and 95^th percentile values of each parameter were compared between PCNSLs and GBMs. The area under the receiver operating characteristic curve (AUC) values were used to compare the discriminating performances among the indices. Results: In enhancing regions, the mean and fifth and 95^th percentile values of ADC<inf>44.5 ms</inf> and ADC<inf>7.1 ms</inf> in PCNSLs were significantly lower than those in GBMs (p = 0.02 for 95^th percentile of ADC<inf>44.5 ms</inf>, p = 0.04 for ADC<inf>7.1 ms</inf>, and p < 0.01 for others). Furthermore, the mean and fifth and 95^th percentile values of cADC and rcADC were significantly higher in PCNSLs than in GBMs (each p < 0.01). The AUC of the best-performing index for ADC<inf>7.1 ms</inf> was significantly lower than that for ADC<inf>44.5 ms</inf> (p < 0.001). The mean rcADC showed the highest discriminating performance (AUC = 0.920) among all indices. In peritumoral regions, no significant difference in any of the three indices of ADC<inf>44.5 ms</inf>, ADC<inf>7.1 ms</inf>, cADC, and rcADC was observed between PCNSLs and GBMs. Conclusions: Effective diffusion time setting can have a crucial impact on the performance of ADC in differentiating between PCNSLs and GBMs. The time-dependent diffusion MRI parameters may be useful in the differentiation of these lesions.

DOI： 10.1186/s40644-023-00639-7

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PubMed

記述言語：日本語   出版者・発行元：Cancer Imaging  

Background: This study was designed to investigate the use of time-dependent diffusion magnetic resonance imaging (MRI) parameters in distinguishing between glioblastomas and brain metastases. Methods: A retrospective study was conducted involving 65 patients with glioblastomas and 27 patients with metastases using a diffusion-weighted imaging sequence with oscillating gradient spin-echo (OGSE, 50 Hz) and a conventional pulsed gradient spin-echo (PGSE, 0 Hz) sequence. In addition to apparent diffusion coefficient (ADC) maps from two sequences (ADC<inf>50Hz</inf> and ADC<inf>0Hz</inf>), we generated maps of the ADC change (cADC): ADC<inf>50Hz</inf> − ADC<inf>0Hz</inf> and the relative ADC change (rcADC): (ADC<inf>50Hz</inf> − ADC<inf>0Hz</inf>)/ ADC<inf>0Hz</inf> × 100 (%). Results: The mean and the fifth and 95th percentile values of each parameter in enhancing and peritumoral regions were compared between glioblastomas and metastases. The area under the receiver operating characteristic curve (AUC) values of the best discriminating indices were compared. In enhancing regions, none of the indices of ADC<inf>0Hz</inf> and ADC<inf>50Hz</inf> showed significant differences between metastases and glioblastomas. The mean cADC and rcADC values of metastases were significantly higher than those of glioblastomas (0.24 ± 0.12 × 10⁻³mm²/s vs. 0.14 ± 0.03 × 10⁻³mm²/s and 23.3 ± 9.4% vs. 14.0 ± 4.7%; all p < 0.01). In peritumoral regions, no significant difference in all ADC indices was observed between metastases and glioblastomas. The AUC values for the mean cADC (0.877) and rcADC (0.819) values in enhancing regions were significantly higher than those for ADC<inf>0Hz</inf>^5th (0.595; all p < 0.001). Conclusions: The time-dependent diffusion MRI parameters may be useful for differentiating brain metastases from glioblastomas.

DOI： 10.1186/s40644-023-00595-2

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PubMed

記述言語：日本語   出版者・発行元：(公社)日本医学放射線学会  

記述言語：日本語   出版者・発行元：Pancreas  

Objective The aim of the study is to evaluate the usefulness of virtual monoenergetic imaging (VMI) generated from dual-energy computed tomography (DECT) in detecting small pancreatic ductal adenocarcinomas (PDACs). Methods This study included 82 patients pathologically diagnosed with small PDAC (≤30 mm) and 20 without pancreatic tumors who underwent triple-phase contrast-enhanced DECT. To assess diagnostic performance for small PDAC detection via a receiver operating characteristic analysis, 3 observers reviewed 2 image sets (conventional computed tomography [CT] set and combined image set [conventional CT + 40-keV VMI from DECT]). The tumor-To-pancreas contrast-To-noise ratio was compared between conventional CT and 40-keV VMI from DECT. Results The area under the receiver operating characteristic curve of the 3 observers were 0.97, 0.96, and 0.97 in conventional CT set and 0.99, 0.99, and 0.99 in combined image set (P = 0.017-0.028), respectively. The combined image set yielded a better sensitivity than the conventional CT set (P = 0.001-0.023), without a loss of specificity (all P > 0.999). The tumor-To-pancreas contrast-To-noise ratios of 40-keV VMI from DECT were approximately threefold higher than those of conventional CT at all phases. Conclusions The addition of 40-keV VMI from DECT to conventional CT had better sensitivity for detecting small PDACs without compromising specificity.

DOI： 10.1097/MPA.0000000000002207

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PubMed

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