|
フククラ ヨシヒコ
Yoshihiko Fukukura
福倉 良彦 所属 川崎医科大学 医学部 臨床医学 機能・代謝画像診断学 職種 教授 |
|
| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Adding Delayed Phase Images to Dual-Phase Contrast-Enhanced CT Increases Sensitivity for Small Pancreatic Ductal Adenocarcinoma. |
| 掲載誌名 | 正式名：AJR. American journal of roentgenology 略 称：AJR Am J Roentgenol ISSNコード：15463141/0361803X |
| 掲載区分 | 国外 |
| 巻・号・頁 | 217(4),pp.888-897 |
| 著者・共著者 | Yoshihiko Fukukura, Yuichi Kumagae, Yosuke Fujisaki, Ryoji Yamagishi, Shinya Nakamura, Junki Kamizono, Masanori Nakajo, Kiyohisa Kamimura, Hiroaki Nagano, Koji Takumi, Takashi Yoshiura |
| 発行年月 | 2021/10 |
| 概要 | BACKGROUND. Contrast-enhanced CT performed for pancreatic ductal adeno-carcinoma (PDAC) detection traditionally uses a dual-phase (pancreatic and portal venous) protocol. However, PDAC may exhibit isoattenuation in these phases, hindering detection. OBJECTIVE. The purpose of this study was to assess the impact on diagnostic performance in detection of small PDAC when a delayed phase is added to dual-phase contrast-enhanced CT. METHODS. A database of 571 patients who underwent triple-phase (pancreatic, portal venous, and delayed) contrast-enhanced MDCT between January 2017 and March 2020 for suspected pancreatic tumor was retrospectively reviewed. A total of 97 patients had pathologically confirmed small PDAC (mean size, 22 mm; range, 7-30 mm). Twenty control patients had no pancreatic tumor suspected on CT, on initial MRI and follow-up CT, or on MRI after 12 months or longer. Three radiologists independently reviewed dual-phase and triple-phase images. Two additional radiologists assessed tumors' visual attenuation on each phase, reaching consensus for differences. Performance of dual- and triple-phase images were compared using ROC analysis, McNemar test, and Fisher exact test. RESULTS. AUC was higher (p < .05) for triple-phase than dual-phase images for all observers (observer 1, 0.97 vs 0.94; observer 2, 0.97 vs 0.94; observer 3, 0.97 vs 0.95). Sensitivity was higher (p < .001) for triple-phase than dual-phase images for all observers (observer 1, 74.2% [72/97] vs 59.8% [58/97]; observer 2, 88.7% [86/97] vs 71.1% [69/97]; observer 3, 86.6% [84/97] vs 72.2% [70/97]). Specificity, PPV, and NPV did not differ between image sets for any reader (p ≥ .05). Seventeen tumors showed pancreatic phase visual isoattenuation, of which nine showed isoattenuation and eight hyperattenuation in the delayed phase. Of these 17 tumors, 16 were not detected by any observer on dual-phase images; of these 16, six were detected by at least two observers and five by at least one observer |
| DOI | 10.2214/AJR.20.25430 |
| PMID | 33759561 |