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Twenty-five patients with pancreatic cancer undergoing contrast-enhanced DECT were analyzed, generating low-keV (50 KeV) and conventional CT-equivalent (70 KeV) images. Tumor-to-pancreas contrast in Hounsfield units was computed, showing higher contrast for 50 KeV than conventional in the parenchymal phase and improved contrast effect for tumors under 20 mm on delayed-phase 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Phases for Pancreatic Cancer  \nYusuke Kurita 1, *, Daisuke Utsunomiya 2, Kensuke Kubota 1, Shingo Koyama 2, Sho Hasegawa 1, Kunihiro Hosono 1, Kuniyasu Irie 3, Yuichi Suzuki 3, Shin Maeda 3, Noritoshi Kobayashi 4, Yasushi Ichikawa 4, Itaru Endo 5 and Atsushi Nakajima 1  \nCitation: Kurita, Y.; Utsunomiya, D.; Kubota, K.; Koyama, S.; Hasegawa, S.; Hosono, K.; Irie, K.; Suzuki, Y.; Maeda, S.; Kobayashi, N.; et al. Diagnostic Value of Contrast-Enhanced DualEnergy Computed Tomography in the Pancreatic Parenchymal and Delayed Phases for Pancreatic Cancer.  \nTomography 2024, 10, 1591–1604 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)tomography10100117  \nAcademic Editor: Emilio Quaia  \nReceived: 23 August 2024  \nRevised: 28 September 2024  \nAccepted: 3 October 2024  \nPublished: 7 October 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \n1 Department of Gastroenterology and Hepatology, Yokohama City University, Yokohama 236-0004, Japan; [kubotak@yokohama-cu.ac.jp](kubotak@yokohama-cu.ac.jp) (K.K.); [t166064d@yokohama-cu.ac.jp](t166064d@yokohama-cu.ac.jp) (S.H.); [hiro1017@yokohama-cu.ac.jp](hiro1017@yokohama-cu.ac.jp) (K.H.); [nakajima.ats.dr@yokohama-cu.ac.jp](nakajima.ats.dr@yokohama-cu.ac.jp) (A.N.)  \n2 Department of Diagnostic Radiology, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan; [d_utsuno@yokohama-cu.ac.jp](d_utsuno@yokohama-cu.ac.jp) (D.U.); [singo109@yokohama-cu.ac.jp](singo109@yokohama-cu.ac.jp) (S.K.)  \n3 Department of Gastroenterology, Yokohama City University, Yokohama 236-0004, Japan; [k_irie@yokohama-cu.ac.jp](k_irie@yokohama-cu.ac.jp) (K.I.); [suzuki.yui.ar@yokohama-cu.ac.jp](suzuki.yui.ar@yokohama-cu.ac.jp) (Y.S.); [smaeda@yokohama-cu.ac.jp](smaeda@yokohama-cu.ac.jp) (S.M.)  \n4 Department of Oncology, Yokohama City University, Yokohama 236-0004, Japan; [norikoba@yokohama-cu.ac.jp](norikoba@yokohama-cu.ac.jp) (N.K.); [yasu0514@yokohama-cu.ac.jp](yasu0514@yokohama-cu.ac.jp) (Y.I.)  \n5 Department of Gastroenterological Surgery, Yokohama City University, Yokohama 236-0004, Japan; [endoit@yokohama-cu.ac.jp](endoit@yokohama-cu.ac.jp)  \n* Correspondence: [kuritay@yokohama-cu.ac.jp](kuritay@yokohama-cu.ac.jp); Tel.: +81-45-787-2800  \nAbstract: Background/Objectives: The usefulness of dual-energy computed tomography (DECT) for low absorption in the parenchymal phase and contrast effects in the delayed phase for pancreatic cancer is not clear. Therefore, the diagnostic capability of low-KeV images obtained using DECT for pancreatic cancer in the pancreatic parenchymal and delayed phases was evaluated quantitatively and qualitatively. Methods: Twenty-five patients with pancreatic cancer who underwent contrastenhanced DECT were included. A total of 50 and 70 KeV CT images, classified as low-keV and conventional CT-equivalent images, were produced, respectively. The tumor-to-pancreas contrast (Hounsfield units [HU]) in the pancreatic parenchymal and delayed phases was calculated by subtracting the CT value of the pancreatic tumor from that of normal parenchyma. Results: The median tumor-to-pancreas contrast on 50 KeV CT in the pancreatic parenchymal phase (133 HU) was higher than that on conventional CT (68 HU) (p \u003C 0.001) . The median tumor-to-pancreas contrast in the delayed phase was −28 HU for 50 KeV CT and −9 HU for conventional CT (p = 0.545) . For tumors \u003C 20 mm, the tumor-to-pancreas contrast of 50 KeV CT (−39 HU) had a significantly clearer contrast effect than that of conventional CT (−16.5 HU), even in the delayed pha","cbCaiak0oc6RqXb4","https://ap.wps.com/l/cbCaiak0oc6RqXb4","pdf",3541763,14,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Clinical significance of early detection\n## Limitations of conventional imaging\n## Role of low-kilovoltage CT and DECT","[{\"question\":\"What problem does the study address for pancreatic cancer imaging?\",\"answer\":\"It targets uncertainty about how DECT low-absorption effects in the parenchymal phase and contrast effects in the delayed phase can improve visualization of pancreatic cancer, especially for early detection.\"},{\"question\":\"How was the diagnostic contrast measured in this research?\",\"answer\":\"The study produced 50 KeV low-keV images and conventional CT-equivalent images, then calculated tumor-to-pancreas contrast by subtracting normal parenchyma CT values from tumor CT values in the parenchymal and delayed phases.\"},{\"question\":\"What were the key findings regarding 50 KeV images?\",\"answer\":\"Tumor-to-pancreas contrast on 50 KeV CT was higher than conventional CT in the parenchymal phase, and small tumors (\\u003c20 mm) showed a significantly clearer contrast effect on 50 KeV delayed-phase images.\"}]","Diagnostic Value of Contrast-Enhanced Dual-Energy Computed Tomography in the Pancreatic Parenchymal and Delayed Phases for Pancreatic Cancer | PDF",1790035767,35]