Value of dual-energy spectral computed tomography for multiparametric quantitative assessment of pancreatic fat content

Background: Dual Energy spectral computed tomography (DECT) provides a variety of image data sets that can be used to improve the assessment of fat content. Purpose To investigate the clinical value of DECT in the quantitative assessment of pancreatic fat content in patients with type 2 diabetes mellitus (T2DM). Material and Methods The DECT data of 123 patients were retrospectively analyzed, including a case group of 82 patients with T2DM and a control group of 41 patients with normal physical examination findings. The CT value, fat (water) concentration and slope of the spectral curve were measured in both groups. The T2DM group was divided into the T2DM obese subgroup (body mass index [BMI] of ≥ 25 kg/m 2 ) and T2DM non-obese subgroup (BMI of < 25 kg/m 2 ) according to the Asia-Pacific classification criteria for BMI. The differences between the T2DM non-obese subgroup and the control group and between the T2DM obese subgroup and the T2DM non-obese subgroup were compared, and the correlation of the BMI with the fat (water) concentration, CT value, and slope was analyzed in all patients with T2DM. Results The CT value was significantly lower and the fat (water) concentration and slope were significantly higher in the T2DM obese subgroup than in the control group ( P <  0.05 for all). The BMI was positively correlated with the fat (water) concentration and slope (r = 0.350 and 0.372, respectively; P <  0.01) and negatively correlated with the CT value (r = − 0.508, P <  0.01). Conclusion DECT is noninvasive and effective for quantitative assessment of the pancreatic fat content.