医学
胰腺导管腺癌
生物标志物
核医学
腺癌
化疗
胰腺癌
主动脉
放射科
癌症
内科学
生物化学
化学
作者
Nobuhiro Fujita,Yasuhiro Ushijima,Masahiro Itoyama,Daisuke Okamoto,Keisuke Ishimatsu,Noriaki Wada,Seiichiro Takao,Ryo Murayama,Nao Fujimori,Kohei Nakata,Masafumi Nakamura,Takeo Yamamoto,Yoshinao Oda,Kousei Ishigami
标识
DOI:10.1016/j.ejrad.2023.110756
摘要
Purpose To clarify the relationship between extracellular volume (ECV) measured by dual-energy CT (DECT) and efficacy of preoperative neoadjuvant chemotherapy (NAC) in patients with pancreatic ductal adenocarcinoma (PDAC), as compared with single-energy CT (SECT). Methods We enrolled 67 patients with PDAC who underwent dynamic contrast-enhanced CT with a dual-energy CT system prior to NAC. Attenuation values were measured on unenhanced and the equilibrium-phase 120-kVp equivalent CT images for PDAC and the aorta. ΔHU-tumor, ΔHU-tumor/ΔHU-aorta, and SECT-ECV were calculated. Iodine densities of the tumor and aorta were measured in the equilibrium phase, and DECT-ECV of the tumor was calculated. Response to NAC was evaluated and the correlation between imaging parameters and response to NAC was statistically assessed. Results Tumor DECT-ECVs were significantly lower in the response group (n = 7) than in the non-response group (n = 60), with most significant difference (p = 0.0104). DECT-ECV showed highest diagnostic value with an Az value of 0.798. When using the optimal cut off value of DECT-ECV (<26.0 %), sensitivity, specificity, accuracy, positive predictive value, and negative value for predicting response group were 71.4 %, 85.0 %, 83.6 %, 35.7 % and 96.2 %, respectively. Conclusion PDAC with lower DECT-ECV can potentially show better response to NAC. DECT-ECV might be a useful biomarker for predicting response to NAC in patients with PDAC.
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