Optimization of peripancreatic vessels visualization using spectral CT virtual monoenergetic imaging in patients with pancreatic malignant tumors_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LI Yu ¹ , WANG Yuqi ¹ , YU Haopeng ¹ , LIU Liqiong ¹ , XUE Qianyuan ¹ , SHUAI Tao ¹ ,  SONG Bin ^1,2,3

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
3. Department of Radiology, Sanya People’s Hospital, Sanya, Hainan 57200, P. R. China;

Corresponding author：

SONG Bin, Email: songlab_radiology@163.com

Keywords：

peripancreatic great vessels; pancreatic cancer; spectral CT; monoenergetic image

DOI：

10.7507/1007-9424.202505014

Video：

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Objective To evaluate the value of spectral CT monoenergetic imaging in optimizing the image quality of peripancreatic great vessels in patients with pancreatic malignant tumors. Methods The imaging data of 62 patients with pancreatic malignant tumors who underwent contrast-enhanced spectral CT at West China Hospital of Sichuan University from July 2018 to March 2021 were retrospectively analyzed. A total of 21 monoenergetic image sets (from 40 to 140 keV at 5 keV intervals) were reconstructed. The CT value, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) of the peripancreatic great vessels (including the celiac artery, common hepatic artery, superior mesenteric artery, portal vein, and superior mesenteric vein), as well as the tumor-to-parenchyma ratio (TPR) in the pancreatic parenchymal and portal venous phases, were compared between the mixed-energy images and the monoenergetic images. Additionally, subjective evaluations of vascular involvement in both the mixed-energy and optimal monoenergetic images were performed. Results There were significant differences in the CT values, SNR, and CNR of peripancreatic vessels between the mixed energy images and the 40–140 keV groups (all P<0.001). The 40 keV group showed higher CT values, SNR, and CNR than both the mixed energy images and the 75–140 keV groups (all P<0.001). The performance was more prominent when using 40 keV images. The subjective evaluation agreement between the two radiologists was good to excellent, with Kappa values ranging from 0.704 to 1.000 (all P<0.001). Conclusion The 40 keV images from spectral CT can significantly optimize the imaging of peripancreatic great vessels, providing better subjective and objective image quality.

1.	Siegel RL, Kratzer TB, Giaquinto AN, et al. Cancer statistics, 2025. CA Cancer J Clin, 2025, 75(1): 10-45.
2.	Halbrook CJ, Lyssiotis CA, Pasca di Magliano M, et al. Pancreatic cancer: Advances and challenges. Cell, 2023, 186(8): 1729-1754.
3.	Klein AP. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol, 2021, 18(7): 493-502.
4.	. National Comprehensive Cancer Network. Pancreatic Adenocarcinoma, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology . 2024. NCCN Guidelines Panel Disclosures.
5.	中国医师协会胰腺病学专业委员会, 国家消化系统疾病临床医学研究中心(上海). 中国胰腺实性肿瘤影像学诊断报告规范循证学指南. 中华胰腺病杂志, 2024, 24(2): 100-113.
6.	Zhang L, Sanagapalli S, Stoita A. Challenges in diagnosis of pancreatic cancer. World J Gastroenterol, 2018, 24(19): 2047-2060.
7.	Joo I, Lee JM, Lee ES, et al. Preoperative CT Classification of the Resectability of Pancreatic Cancer: Interobserver Agreement. Radiology, 2019, 293(2): 343-349.
8.	Albrecht MH, Vogl TJ, Martin SS, et al. Review of Clinical Applications for Virtual Monoenergetic Dual-Energy CT. Radiology, 2019, 293(2): 260-271.
9.	Wang S, Zhang Y, Xu Y, et al. Progress in the application of dual-energy CT in pancreatic diseases. Eur J Radiol, 2023 Nov: 168: 111090.
10.	Ahmed SA, Atta H, Hassan RA. The utility of Multi-Detector Computed Tomography criteria after neoadjuvant therapy in Borderline Resectable Pancreatic cancer: Prospective, bi-institutional study. Eur J Radiol, 2021 Jun: 139: 109685.
11.	Lee W, Park HJ, Lee YN, et al. Computed tomography-based vascular burden index as a predictor of vascular resection and pathological vascular invasion in pancreatic cancer with neo-adjuvant chemotherapy. Eur J Surg Oncol, 2024, 50(9): 108494.
12.	辛彦杰, 姜慧杰, 赵成磊. 能谱CT在血管成像中的应用进展. 国际医学放射学杂志, 2023, 46(3): 326-332.
13.	林晓珠, 沈云, 陈克敏. CT能谱成像的基本原理与临床应用研究进展. 中华放射学杂志, 2011, 45(8): 798-800.
14.	中华医学会放射学分会, 中国医师协会放射医师分会, 安徽省影像临床医学研究中心. 能量CT临床应用中国专家共识. 中华放射学杂志, 2022, 56(5): 476-487.
15.	Liang H, Zhou Y, Zheng Q, et al. Dual-energy CT with virtual monoenergetic images and iodine maps improves tumor conspicuity in patients with pancreatic ductal adenocarcinoma. Insights Imaging, 2022, 13(1): 153. doi: 10.1186/s13244-022-01297-2.
16.	杨琰昭, 常蕊, 王晴柔, 等. 双层探测器光谱CT虚拟单能量图像在胰腺导管腺癌术前评估中的优化研究. 上海交通大学学报(医学版), 2022, 42(9): 1323-1328.
17.	Tanaka M, Fernández-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology, 2017, 17(5): 738-753.
18.	European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut, 2018, 67(5): 789-804.

1. Siegel RL, Kratzer TB, Giaquinto AN, et al. Cancer statistics, 2025. CA Cancer J Clin, 2025, 75(1): 10-45.
2. Halbrook CJ, Lyssiotis CA, Pasca di Magliano M, et al. Pancreatic cancer: Advances and challenges. Cell, 2023, 186(8): 1729-1754.
3. Klein AP. Pancreatic cancer epidemiology: understanding the role of lifestyle and inherited risk factors. Nat Rev Gastroenterol Hepatol, 2021, 18(7): 493-502.
4. . National Comprehensive Cancer Network. Pancreatic Adenocarcinoma, Version 2.2024, NCCN Clinical Practice Guidelines in Oncology . 2024. NCCN Guidelines Panel Disclosures.
5. 中国医师协会胰腺病学专业委员会, 国家消化系统疾病临床医学研究中心(上海). 中国胰腺实性肿瘤影像学诊断报告规范循证学指南. 中华胰腺病杂志, 2024, 24(2): 100-113.
6. Zhang L, Sanagapalli S, Stoita A. Challenges in diagnosis of pancreatic cancer. World J Gastroenterol, 2018, 24(19): 2047-2060.
7. Joo I, Lee JM, Lee ES, et al. Preoperative CT Classification of the Resectability of Pancreatic Cancer: Interobserver Agreement. Radiology, 2019, 293(2): 343-349.
8. Albrecht MH, Vogl TJ, Martin SS, et al. Review of Clinical Applications for Virtual Monoenergetic Dual-Energy CT. Radiology, 2019, 293(2): 260-271.
9. Wang S, Zhang Y, Xu Y, et al. Progress in the application of dual-energy CT in pancreatic diseases. Eur J Radiol, 2023 Nov: 168: 111090.
10. Ahmed SA, Atta H, Hassan RA. The utility of Multi-Detector Computed Tomography criteria after neoadjuvant therapy in Borderline Resectable Pancreatic cancer: Prospective, bi-institutional study. Eur J Radiol, 2021 Jun: 139: 109685.
11. Lee W, Park HJ, Lee YN, et al. Computed tomography-based vascular burden index as a predictor of vascular resection and pathological vascular invasion in pancreatic cancer with neo-adjuvant chemotherapy. Eur J Surg Oncol, 2024, 50(9): 108494.
12. 辛彦杰, 姜慧杰, 赵成磊. 能谱CT在血管成像中的应用进展. 国际医学放射学杂志, 2023, 46(3): 326-332.
13. 林晓珠, 沈云, 陈克敏. CT能谱成像的基本原理与临床应用研究进展. 中华放射学杂志, 2011, 45(8): 798-800.
14. 中华医学会放射学分会, 中国医师协会放射医师分会, 安徽省影像临床医学研究中心. 能量CT临床应用中国专家共识. 中华放射学杂志, 2022, 56(5): 476-487.
15. Liang H, Zhou Y, Zheng Q, et al. Dual-energy CT with virtual monoenergetic images and iodine maps improves tumor conspicuity in patients with pancreatic ductal adenocarcinoma. Insights Imaging, 2022, 13(1): 153. doi: 10.1186/s13244-022-01297-2.
16. 杨琰昭, 常蕊, 王晴柔, 等. 双层探测器光谱CT虚拟单能量图像在胰腺导管腺癌术前评估中的优化研究. 上海交通大学学报(医学版), 2022, 42(9): 1323-1328.
17. Tanaka M, Fernández-Del Castillo C, Kamisawa T, et al. Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas. Pancreatology, 2017, 17(5): 738-753.
18. European Study Group on Cystic Tumours of the Pancreas. European evidence-based guidelines on pancreatic cystic neoplasms. Gut, 2018, 67(5): 789-804.

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