Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma

Fukui, Hideyuki; Fukuda, Yasunari; Onishi, Hiromitsu; Ota, Takashi; Nakamoto, Atsushi; Honda, Toru; Aihara, Ryo; Enchi, Yukihiro; Yamada, Daisaku; Kobayashi, Shogo; Eguchi, Hidetoshi; Tatsumi, Mitsuaki; Tomiyama, Noriyuki

doi:https://doi.org/10.1016/j.ejrad.2025.112246

Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma

Fukui, Hideyuki; Fukuda, Yasunari; Onishi, Hiromitsu et al.

European Journal of Radiology, 2025, 190, 112246

Number of Access:42（2025-09-06 10:36 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/102620

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Title	Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma
Creator	NRID 1000000721101 1000000721101 ORCID 0000-0002-6330-2482 0000-0002-6330-2482 researchmap permalink h-fukui h-fukui Scopus Author ID 57192195026 57192195026 CreatorName Fukui, Hideyuki
	NRID 1000020768973 1000020768973 CreatorName Fukuda, Yasunari
	NRID 1000020452435 1000020452435 researchmap permalink edv edv Scopus Author ID 9240645100 9240645100 CreatorName Onishi, Hiromitsu
	NRID 1000020868088 1000020868088 researchmap permalink takashi_0123 takashi_0123 Scopus Author ID 57194721064 57194721064 CreatorName Ota, Takashi
	NRID 1000020625199 1000020625199 researchmap permalink nakamo10 nakamo10 Scopus Author ID 36778686900 36778686900 CreatorName Nakamoto, Atsushi
	CreatorName Honda, Toru
	CreatorName Aihara, Ryo
	CreatorName Enchi, Yukihiro
	NRID 1000060571396 1000060571396 ORCID 0000-0002-6702-3800 0000-0002-6702-3800 researchmap permalink dyamada79222 dyamada79222 Scopus Author ID 37008067700 37008067700 CreatorName Yamada, Daisaku
	CreatorName Kobayashi, Shogo
	NRID 1000090542118 1000090542118 researchmap permalink abcdabcdabcd abcdabcdabcd Scopus Author ID 7101627772 7101627772 CreatorName Eguchi, Hidetoshi
	NRID 1000060397700 1000060397700 ORCID 0000-0003-1778-0421 0000-0003-1778-0421 researchmap permalink mtatsumi mtatsumi Scopus Author ID 7102266657 7102266657 CreatorName Tatsumi, Mitsuaki
	NRID 1000050294070 1000050294070 researchmap permalink 3430 3430 Scopus Author ID 7006024942 7006024942 CreatorName Tomiyama, Noriyuki
Subject	Computed tomography: X-ray
	Extracellular space
	Pancreatic ductal adenocarcinoma
	Prognosis
	Survival analysis
Description	Fukui H., Fukuda Y., Onishi H., et al. Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma. European Journal of Radiology 190, 112246 (2025); https://doi.org/10.1016/j.ejrad.2025.112246.
Abstract	Objective: To evaluate the prognostic value of the extracellular volume fraction (fECV) derived from contrast-enhanced computed tomography (CE-CT) for recurrence-free survival (RFS) and overall survival (OS) rates after pancreatic ductal adenocarcinoma (PDAC) surgery. Methods: This retrospective study evaluated 71 patients diagnosed with PDAC postsurgery who underwent CE-CT with precontrast and equilibrium phases before neoadjuvant chemotherapy (35 males, 36 females; mean age, 70.3 years; 95 % CI, 68.1–72.6; SD, 9.8; range, 45–89 years), were enrolled. Noncancerous pancreatic parenchyma and pancreatic tumors were automatically segmented from nonenhanced and equilibrium-phase images, excluding focal lesions, major-vessel, and ducts. Uni- and multivariate analyses (Cox proportional hazards model) were performed to evaluate fECV [=(100 − hematocrit) × (ΔPancreas/ΔAorta] in the nonaffected pancreas and tumor, with age, sex, chemotherapeutic scheme, tumor marker/location/size, stage, histological type, RFS, and OS as factors. Time-dependent receiver-operating characteristic curves showed the optimal fECV cutoff values for predicting RFS and OS. Results: Adjuvant chemotherapy regimen, histological type, and fECV of noncancerous pancreatic parenchyma were independent prognostic factors of OS (p < 0.001, 0.049, and 0.018, respectively), and TNM stage (IB) was an independent predictor of RFS (p = 0.025). RFS and OS were worse in patients with noncancerous pancreatic tissue with higher fECV than in those with lower fECV (optimal cutoffs: 40.32 % for RFS, p = 0.036; 43.65 % for OS, p < 0.001). Conclusion: The fECV of noncancerous pancreatic parenchyma from CE-CT was a significant predictor of survival outcomes in PDAC.
Publisher	Elsevier Ireland Ltd
Source Title	European Journal of Radiology
Volume (Issue)	190
Page	112246
Date of Issued	2025-06-20
Language	English
Handle URL	https://hdl.handle.net/11094/102620
PISSN	0720048X
eISSN	18727727
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1016/j.ejrad.2025.112246
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCMI Type	Text
DCTERMS.bibliographicCitation	European Journal of Radiology. 2025, 190, p. 112246
DC.title	Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma
DC.creator	Fukui, Hideyuki
	Fukuda, Yasunari
	Onishi, Hiromitsu
	Ota, Takashi
	Nakamoto, Atsushi
	Honda, Toru
	Aihara, Ryo
	Enchi, Yukihiro
	Yamada, Daisaku
	Kobayashi, Shogo
	Eguchi, Hidetoshi
	Tatsumi, Mitsuaki
	Tomiyama, Noriyuki
DC.publisher	Elsevier Ireland Ltd
DC.language' scheme='DCTERMS.RFC1766	English
DC.type' scheme='DCTERMS.DCMIType	Text
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2025-06-20
DC.identifier	https://doi.org/10.1016/j.ejrad.2025.112246
DC.subject	Computed tomography: X-ray
	Extracellular space
	Pancreatic ductal adenocarcinoma
	Prognosis
	Survival analysis
DC.description	Fukui H., Fukuda Y., Onishi H., et al. Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma. European Journal of Radiology 190, 112246 (2025); https://doi.org/10.1016/j.ejrad.2025.112246.
DCTERMS.abstract	Objective: To evaluate the prognostic value of the extracellular volume fraction (fECV) derived from contrast-enhanced computed tomography (CE-CT) for recurrence-free survival (RFS) and overall survival (OS) rates after pancreatic ductal adenocarcinoma (PDAC) surgery. Methods: This retrospective study evaluated 71 patients diagnosed with PDAC postsurgery who underwent CE-CT with precontrast and equilibrium phases before neoadjuvant chemotherapy (35 males, 36 females; mean age, 70.3 years; 95 % CI, 68.1–72.6; SD, 9.8; range, 45–89 years), were enrolled. Noncancerous pancreatic parenchyma and pancreatic tumors were automatically segmented from nonenhanced and equilibrium-phase images, excluding focal lesions, major-vessel, and ducts. Uni- and multivariate analyses (Cox proportional hazards model) were performed to evaluate fECV [=(100 − hematocrit) × (ΔPancreas/ΔAorta] in the nonaffected pancreas and tumor, with age, sex, chemotherapeutic scheme, tumor marker/location/size, stage, histological type, RFS, and OS as factors. Time-dependent receiver-operating characteristic curves showed the optimal fECV cutoff values for predicting RFS and OS. Results: Adjuvant chemotherapy regimen, histological type, and fECV of noncancerous pancreatic parenchyma were independent prognostic factors of OS (p < 0.001, 0.049, and 0.018, respectively), and TNM stage (IB) was an independent predictor of RFS (p = 0.025). RFS and OS were worse in patients with noncancerous pancreatic tissue with higher fECV than in those with lower fECV (optimal cutoffs: 40.32 % for RFS, p = 0.036; 43.65 % for OS, p < 0.001). Conclusion: The fECV of noncancerous pancreatic parenchyma from CE-CT was a significant predictor of survival outcomes in PDAC.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	102620
citation_title	Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma
citation_author	Fukui, Hideyuki
	Fukuda, Yasunari
	Onishi, Hiromitsu
	Ota, Takashi
	Nakamoto, Atsushi
	Honda, Toru
	Aihara, Ryo
	Enchi, Yukihiro
	Yamada, Daisaku
	Kobayashi, Shogo
	Eguchi, Hidetoshi
	Tatsumi, Mitsuaki
	Tomiyama, Noriyuki
citation_publisher	Elsevier Ireland Ltd
citation_language	English
citation_date	2025-06-20
citation_journal_title	European Journal of Radiology
citation_volume	190
citation_firstpage	112246
citation_doi	https://doi.org/10.1016/j.ejrad.2025.112246
citation_public_url	https://hdl.handle.net/11094/102620

Dynamic contrast-enhanced CT-derived extracellular volume fraction for predicting postoperative oncologic outcomes in pancreatic ductal adenocarcinoma

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