Pancreatic fat fraction in dual-energy computed tomography as a potential quantitative parameter in the detection of type 2 diabetes mellitus. Issue 159 (February 2023) - Huang, Shiqi
Highlights: Dual-energy CT parameters might be used to analyze the relationship between fat infiltration and diabetes mellitus. The DECT fat fractions of the pancreas are higher in the type 2 diabetes group than in the control group. The CT values of the pancreas are lower in the type 2 diabetes group than in the control group. DECT fat map can be used as a potential visual assessment tool to analyze the local infiltration of pancreatic fat. Abstract: Purpose: To investigate the clinical value of measuring pancreatic fat fraction using dual-energy computed tomography (DECT) in association with type 2 diabetes mellitus (T2DM). Materials and methods: This retrospective study included patients who underwent abdominal DECT between September 2021 and July 2022. The fat fractions in the head, body, and tail of the pancreas were calculated using fat maps generated from unenhanced DECT images, and CT values were measured at the same locations. The intraclass correlation coefficient (ICC) was used to analyze the reproducibility of measurements from two observers. Diagnostic performance was assessed using receiver operating characteristic curves. Results: Seventy-eight patients, including 45 T2DM patients and 33 controls, were enrolled. The fat fractions of the pancreas were significantly higher in the T2DM group than in the control group (pancreatic head: 8.4 ± 6.3 % vs 5.1 ± 3.9 %; pancreatic body: 4.8 ± 4.0 % vs 2.7 ± 3.9 %; and pancreatic tail: 5.3 ± 3.2 % vs 2.7 ± 2.9 %, all p < 0.05). And the CT values of the pancreas were significantly lower in the T2DM group than in the control group (pancreatic head: 41.1 ± 8.5 HU vs 45.7 ± 4.6 HU; pancreatic body: 44.4 ± 5.0 HU vs 47.4 ± 3.7 HU; and pancreatic tail: 44.5 ± 5.0 HU vs 47.6 ± 3.2 HU, all p < 0.05). The fat fraction of the pancreatic tail was the best indicator for distinguishing T2DM patients from the controls (area under the curve: 0.716 (95 % CI: 0.601, 0.832), sensitivity: 64.4 % (95 % CI: 48.7 %, 77.7 %), and specificity: 78.8 % (95 % CI: 60.6 %, 90.4 %)). Conclusion: The DECT fat fractions of the pancreas could be a valuable additional parameter in the detection of T2DM.