Optimizing the image quality of peripancreatic blood vessels through the clinical application of single-energy spectral computed tomography (CT) imaging

Background: With the increase of pancreatic tumor patients in recent years, there is an urgent need to find a way to treat pancreatic tumors. Surgery is one of the best methods for the treatment of pancreatic tumors, the success of which depends on the evaluation of peripancreatic vessels before surgery. Computed tomography (CT), as a non-invasive, fast, and economical auxiliary examination method, is undoubtedly one of the best means of clinical auxiliary examination. In this study, we investigated the impact of single-energy spectral CT imaging on the image quality of peripancreatic blood vessels and the clinical value of low-keV imaging in enhancing the image quality of peripancreatic arteriovenous vessels. Methods: We prospectively enrolled 103 patients who underwent abdominal vascular-enhanced CT examinations at the Affiliated Hospital of Hebei University between December 2022 and May 2023 and who were all scanned with the dual-energy feature on the United Imaging ATLAS scanner. The images were reconstructed at 70 keV, mixed energy, and optimized single energy in the post-processing station of United Imaging Healthcare Technology Co., Ltd. The CT value and contrast-to-noise ratio (CNR) of the superior mesenteric artery (SMA), gastroduodenal artery (GDA), inferior pancreaticoduodenal artery (IPDA), and superior mesenteric vein (SMV) were compared across energy levels, and then the image quality was subjectively evaluated. One-way analysis of variance and rank-sum tests were utilized for the statistical analysis. Results: The CT values of SMA, GDA, IPDA, and SMV in the optimal single energy group were 358.37 +/- 70.24, 323.36 +/- 88.23, 300.76 +/- 76.27, and 257.74 +/- 20.56 Hounsfield unit (HU), respectively, which were superior to those in the mixed energy (241.66 +/- 47.69, 235.17 +/- 53.71, 207.36 +/- 45.17, and 187.39 +/- 23.21 HU) and 70 keV groups (260.89 +/- 54.27, 252.41 +/- 58.87, 223.17 +/- 43.65, and 203.18 +/- 18.17 HU) (P<0.05). The diagnostic efficacy was greater in the optimal single energy group than in the other 2 groups (4.63 +/- 0.50, 3.91 +/- 0.57, and 4.23 +/- 0.83) (P<0.05). Conclusions: The optimal single energy for showing peripancreatic blood vessels is 62 +/- 7 keV when utilizing single-energy spectral CT imaging.