ArticleQuantitative imaging in medicine and surgery2025
Evaluation of histological tumor necrosis in pancreatic ductal adenocarcinoma via the quantitative parameters from enhanced computed tomography and its relationship with tumor prognosis.
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. Cited by 1 paper.
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1 citing paper in PubMed.
- Dual-energy CT extracellular volume fraction for predicting the chemotherapeutic response in pancreatic ductal adenocarcinoma.Cancer imaging : the official publication of the International Cancer Imaging Society · 2026Article
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Abstract
Background: Contrast-enhanced computed tomography (CE-CT) is considered the standard tool for depicting, staging, and resecting pancreatic ductal adenocarcinoma (PDAC). This study aimed to assess the utility of CE-CT in evaluating histological tumor necrosis (HTN) in patients with PDAC and to evaluate the prognostic significance of computed tomography (CT)-defined necrosis in patients with resectable PDAC. Methods: Among 1,116 patients with PDAC [our hospital (Shengjing Hospital of China Medical University): 966; external hospitals (Guangdong Provincial People's Hospital and Tianjin Tumor Hospital): 150] undergoing CE-CT and R0 pancreatectomy between January 2010 and December 2020, 328 patients were reevaluated for HTN. CE-CT images were processed using dense energy displacement sampling (DEEDS) and three-dimensional no new UNet (3D-nnUNet) for tumor segmentation. The subtraction map and attenuation difference (delta) of the portal venous phase and the unenhanced phase of the tumor were obtained with a MATLAB script (MathWorks). Necrosis detected by CT was defined as a weak or no-enhancement area on the subtraction image [delta: 10-30 Hounsfield units (HU)]. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance, and Cox models were applied to estimate disease-free survival (DFS) and overall survival (OS). Results: CT-defined necrosis (delta ≤15 HU) demonstrated superior diagnostic efficacy for HTN as compared to other cutoffs and radiologist-diagnosed necrosis [area under the ROC curve (AUC): 0.93 Conclusions: CT-defined necrosis can be used as an objective imaging biomarker to diagnose HTN and preoperatively predict poor prognosis among patients with PDAC.
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