ArticleAbdominal radiology (New York)2026
Preoperative prediction of perineural invasion in pancreatic ductal adenocarcinoma using dual-layer spectral CT.
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
purposePerineural invasion (PNI) is an independent predictive factor for pancreatic ductal adenocarcinoma (PDAC); however, preoperative prediction is difficult. This study aimed to evaluate the value of dual-layer spectral CT (DLCT) parameters in PNI in PDAC. MATERIALS AND
methodsThis retrospective study included patients with pathologically confirmed PDAC who underwent DLCT between August 2019 and March 2024. Risk factors were identified using univariable and least absolute shrinkage and selection operator (LASSO) regression. Receiver operating characteristic (ROC), precision-recall (PR) curves, calibration curves and decision curve analysis (DCA) accessed diagnostic performance.
resultsWe included 100 patients (mean age: 60.88 ± 11.39 years old, 59 males). There were 71 patients with PNI and 29 without PNI. Relevant factors for PNI included tumour diameter, normalised CT attenuation during the pancreatic parenchymal phase in conventional CT (nCTa), normalised CT attenuation during the pancreatic parenchymal phase in DLCT at 40 keV, and normalised iodine concentration during the pancreatic parenchymal phase (nDIa) (odds ratio [OR], 1.34; 95% confidence interval [CI]: 1.19, 1.51; p < 0.001). Of these, nDIa was the only independent predictor (p < 0.001; adjusted OR, 1.41; 95% CI: 1.19, 1.68) and demonstrated superior diagnostic performance compared to nCTa, with a cutoff value of 0.16, higher area under the curve (ROC: 0.86 vs. 0.68, PR: 0.93 vs. 0.84; both p < 0.001), higher accuracy (77.0% vs. 52.0%, p = 0.048), an F
conclusionThe DLCT parameter nDIa allows for non-invasive prediction of PNI in PDAC with superior diagnostic efficacy compared to conventional CT parameters.
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