ArticleQuantitative imaging in medicine and surgery2025
Dual-layer spectral detector computed tomography in distinguishing between bland and neoplastic portal vein thrombosis.
Article in Quantitative imaging in medicine and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Differentiating bland from neoplastic portal vein thrombosis (PVT) is crucial for staging and treatment decisions in patients with suspected or confirmed liver malignancies. This study aimed to assess the diagnostic efficacy of the quantitative parameters of dual-layer spectral detector computed tomography (DLCT) in distinguishing between bland and neoplastic PVT. Methods: This single-center prospective study included consecutive patients with identifiable PVT who underwent contrast-enhanced liver DLCT between April 2022 and August 2023. The reference standard was established based on imaging, patient history, and follow-up data. Quantitative parameters, including computed tomography (CT) attenuation values from conventional and virtual monoenergetic (40-90 keV) images, iodine density, effective atomic number (Zeff), and arterial enhancement fraction (AEF), were documented. Interobserver agreement was assessed via the intraclass correlation coefficient (ICC). A combined score integrating DLCT quantitative parameters was developed, and diagnostic performance was evaluated according to the area under the receiver operating characteristic (ROC) curve (AUC), sensitivity, and specificity. Results: A total of 81 patients (median age 54 years; 64 males) were enrolled, including 31 patients with bland PVT and 50 with neoplastic PVT. Baseline characteristics showed significant differences between the bland PVT and neoplastic PVT groups, including in α-fetoprotein (AFP) level (median 3.3 Conclusions: DLCT quantitative parameters effectively distinguished between bland and neoplastic PVT. The combined score derived from quantitative DLCT parameters demonstrated superior diagnostic performance, potentially aiding in accurate staging and treatment decisions for patients with suspected or confirmed liver malignancies. Further large-scale multicenter studies are needed to confirm these findings.
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