ArticleAbdominal radiology (New York)2026
Quantitative and qualitative evaluation of pancreatic cancer on photon-counting detector CT and dual-energy CT using standard reference images.
Article in Abdominal radiology (New York), 2026. 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
purposeTo compare the depiction performance of photon-counting detector CT (PCD-CT) and dual-energy CT (DE-CT) quantitatively and qualitatively for pancreatic cancer under reference conditions equivalent to 120 kVp, used in clinical practice.
methodFor this retrospective single-center study, 124 patients with pathologically proven pancreatic cancer who had undergone initial dynamic contrast-enhanced upper abdominal CT between January 2023 and October 2024 were included (PCD-CT: n = 62; DE-CT: n = 62). Reference images were 70 keV virtual monoenergetic images for PCD-CT and 80/Sn150 kVp linearly blended images for DE-CT. The tumor-to-pancreas ratio (TPR) and contrast-to-noise ratio (CNR) were calculated in the pancreatic and equilibrium phases. After two radiologists rated tumor visibility independently using a five-point scale, the mean visibility score was analyzed. Group differences were assessed using Welch's t test and linear regression adjusted for age, body mass index (BMI), tumor size, and tumor location. A predefined subgroup analysis was conducted for tumors ≤ 20 mm (pancreatic phase).
resultIn the equilibrium phase, the visibility score was higher with PCD-CT than with DE-CT (3.065 vs. 2.548; p < 0.001) and remained significant after adjustment (β = +0.305; p = 0.032). TPR and CNR were similar in both phases (pancreatic: TPR 0.495 vs. 0.537, p = 0.088; CNR 13.789 vs. 12.231, p = 0.246; equilibrium: TPR 1.027 vs. 1.017, p = 0.868; CNR 0.901 vs. 0.110, p = 0.597), as was pancreatic-phase visibility (4.250 vs. 4.065; p = 0.136). Results for tumors ≤ 20 mm were consistent with the main analysis.
conclusionUnder 120 kVp-equivalent conditions, PCD-CT and DE-CT showed comparable quantitative performance for pancreatic cancer, whereas PCD-CT provided superior subjective tumor visibility in the equilibrium phase, suggesting improved visual detectability without loss of quantitative image quality.
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