caa a22 4500 605495084 CHVBK 20210128100529.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s00261-014-0274-y doi (NATIONALLICENCE)springer-10.1007/s00261-014-0274-y Multireader evaluation of lesion conspicuity in small pancreatic adenocarcinomas: complimentary value of iodine material density and low keV simulated monoenergetic images using multiphasic rapidkVp-switching dual energy CT [Elektronische Daten] [Michelle McNamara, Mark Little, Lauren Alexander, L. Van Carroll, T. Mark Beasley, Desiree Morgan] Objective: Perform multireader analysis of objective and subjective lesion conspicuity for small pancreatic adenocarcinomas using rapid switching dual energy CT (rsDECT). Materials and methods: With IRB approval, 51 abdominal multiphasic rsDECT scans in 46 subjects with small (<3cm) pancreatic adenocarcinomas were retrospectively reviewed by three independent readers for objective and subjective lesion conspicuity. Measured variables during individual, blinded interpretive sessions of separate low (52)keV, PACS-equivalent (70)keV, and iodine material density (MD) image sets included Hounsfield units (HU) and mg/cc iodine for tumor, nontumoral pancreas, and subcutaneous fat. Objective measures included absolute lesion contrast (LC) and contrast to noise ratios (CNR). Subjective measures included image quality, lesion conspicuity, and reader confidence. Reader agreement was measured with kappa statistic; correlation with truth by Pearson coefficient, CNR with repeated mANOVA; subjective quality measures utilized Tukey-Cramer corrections for multiple testing, p<0.05 considered significant. Results: Demographics: 26 F, 20M, mean age 68years, weight 75kg, tumor size of 2.3cm. LC was highest on 52keV images for all three readers (mean 90.1 HU). Mean CNR for iodine MD images (4.87) was significantly higher than 52keV (4.13) or 70keV (3.9). Very high to near-perfect kappa values were observed for all individual measured objective variables but were best for 52keV images (52keV 0.89-0.95, 70keV 0.76-0.83, iodine 0.87-0.92). 70keV images scored best for subjective image quality; iodine MD images scored best for lesion conspicuity and reader confidence. Conclusion: We observed very high reader agreement for independent objective rsDECT image variables and subjective rsDECT image scores in patients with small pancreatic adenocarcinomas. Maximal objective tumor to nontumoral LC was depicted on 52keV and highest CNR on iodine MD images; readers scored the iodine MD images best for lesion conspicuity and confidence. Springer Science+Business Media New York, 2014 Dual energy CT nationallicence Pancreas nationallicence Ductal adenocarcinoma nationallicence Multireader agreement nationallicence McNamara Michelle Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut Little Mark Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut Alexander Lauren Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA aut Van Carroll L. University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA aut Mark Beasley T. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA aut Morgan Desiree Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1230-1240 0942-8925 40:5<1230 2015 40 261 https://doi.org/10.1007/s00261-014-0274-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-014-0274-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- McNamara Michelle Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut NATIONALLICENCE 700 1- Little Mark Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut NATIONALLICENCE 700 1- Alexander Lauren Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA aut NATIONALLICENCE 700 1- Van Carroll L. University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA aut NATIONALLICENCE 700 1- Mark Beasley T. Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA aut NATIONALLICENCE 700 1- Morgan Desiree Department of Radiology, School of Medicine, University of Alabama at Birmingham, JTN452, 619 South 19th Street, 35249, Birmingham, AL, USA aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/5(2015-06-01), 1230-1240 0942-8925 40:5<1230 2015 40 261