Low tube voltage CT for improved detection of pancreatic cancer: detection threshold for small, simulated lesions

BMC Medical Imaging

Research Article

Nikolaos Kartalis¹  Nils Albiin¹  Louiza Loizou¹  Bertil Leidner¹  Anders Sundin²  Jon Holm³ 

[1]Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 17177, Stockholm, Sweden

[2]Department of Radiology, Karolinska University Hospital, 14186, HuddingeStockholm, Sweden

[3]Department of Radiology, Karolinska University Hospital, 17176, SolnaStockholm, Sweden

[4]Department of Molecular Medicine and Surgery, Karolinska Institutet, 17176, Stockholm, Sweden

[5]Division of Medical Physics, Karolinska University Hospital, 14186, Huddinge, Stockholm, Sweden

[6]Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, 17177, Stockholm, Sweden

关键词: Pancreatic adenocarcinoma;    CT;    Low tube voltage;    Phantom;   

DOI  :  10.1186/1471-2342-12-20

 received in 2012-03-19, accepted in 2012-07-24,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundPancreatic ductal adenocarcinoma is associated with dismal prognosis. The detection of small pancreatic tumors which are still resectable is still a challenging problem.The aim of this study was to investigate the effect of decreasing the tube voltage from 120 to 80 kV on the detection of pancreatic tumors.MethodsThree scanning protocols was used; one using the standard tube voltage (120 kV) and current (160 mA) and two using 80 kV but with different tube currents (500 and 675 mA) to achieve equivalent dose (15 mGy) and noise (15 HU) as that of the standard protocol.Tumors were simulated into collected CT phantom images. The attenuation in normal parenchyma at 120 kV was set at 130 HU, as measured previously in clinical examinations, and the tumor attenuation was assumed to differ 20 HU and was set at 110HU. By scanning and measuring of iodine solution with different concentrations the corresponding tumor and parenchyma attenuation at 80 kV was found to be 185 and 219 HU, respectively.To objectively evaluate the differences between the three protocols, a multi-reader multi-case receiver operating characteristic study was conducted, using three readers and 100 cases, each containing 0–3 lesions.ResultsThe highest reader averaged figure-of-merit (FOM) was achieved for 80 kV and 675 mA (FOM = 0,850), and the lowest for 120 kV (FOM = 0,709). There was a significant difference between the three protocols (p < 0,0001), when making an analysis of variance (ANOVA). Post-hoc analysis (students t-test) shows that there was a significant difference between 120 and 80 kV, but not between the two levels of tube currents at 80 kV.ConclusionWe conclude that when decreasing the tube voltage there is a significant improvement in tumor conspicuity.

【 授权许可】

CC BY   
© Holm et al.; licensee BioMed Central Ltd. 2012