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Iodine Quantification in the Tumor and Healthy Tissue of the Pancreas and Liver From Split-Filter DECT Iodine-Enhancement Images

L DiMaso1*, J Huang2 , M Lawless2 , M Bassetti2 , L DeWerd1 , J Miller2 , (1) Dept of Med Phys, School of Medicine and Public Health, Univ of Wisc - Madison (2) Dept of Human Oncology, School of Medicine and Public Health, Univ of Wisc - Madison


(Sunday, 7/14/2019) 2:00 PM - 3:00 PM

Room: 221AB

Purpose: To investigate the iodine uptake within tumor and healthy tissue of the pancreas and liver from split-filter DECT iodine-enhancement images. This work investigates the relationship between iodine uptake, tumor visibility and patient size.

Methods: Pancreas (n=19) and liver (n=19) patients were imaged with split-filter DECT for radiation treatment planning with 100 ml of iodinated contrast medium. Iodine-enhancement images and mixed 120 kVp-equivalent images were generated in Syngo.via (Siemens Healthineers). The gross target volume (GTV) and healthy tissue were contoured by a radiation oncologist using MIMvista. Tumor visibility was assessed by calculating the GTV contrast-to-noise ratio on the mixed 120 kVp-equivalent images. The iodine concentration within the GTV and healthy tissue was calculated using size-specific calibration curves calculated from the Gammex Multi-Energy CT head and abdomen phantom. The iodine concentration was correlated with patient size and tumor visibility.

Results: The effective diameter of the patients ranged from 23.5 to 40.2 cm. The iodine concentration within the healthy pancreatic tissue was statistically greater than the pancreas GTV (p<0.05). The iodine concentration within the hypo-attenuating liver GTV was statistically less than surrounding liver tissue (p<0.05). The iodine concentration within the hyper-attenuating liver GTV was statistically greater than surrounding liver tissue (p<0.05). Increased tumor visibility correlated with increased iodine concentration in the healthy pancreas tissue (r² =0.402), no correlation was found in the liver (r²=0.011). Iodine uptake in the GTV decreased with patient size (r²=0.318), no correlation was found in the healthy tissue (r²=0.042).

Conclusion: The decrease in iodine concentration with patient size was quantified. Greater tumor visibility on the mixed images corresponded to an increase in iodine uptake in healthy pancreas tissue. This trend was not present in the liver. There was a statistically significant difference between iodine uptake in the GTV and healthy tissue using split-filter DECT.


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