{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T12:12:03Z","timestamp":1778760723693,"version":"3.51.4"},"reference-count":27,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T00:00:00Z","timestamp":1770249600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010816","name":"Anhui Science and Technology Department","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010816","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009076","name":"USTC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82271991"],"award-info":[{"award-number":["82271991"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016073","name":"Key Technologies Research and Development Program of Anhui Province","doi-asserted-by":"publisher","award":["2022e07020007"],"award-info":[{"award-number":["2022e07020007"]}],"id":[{"id":"10.13039\/100016073","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["academicradiology.org","clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Academic Radiology"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.acra.2026.01.044","type":"journal-article","created":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T19:57:59Z","timestamp":1771703879000},"page":"2442-2454","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Noninvasive Prediction of Tumor Malignancy Grade in Pancreatic Ductal Adenocarcinoma with Dual-Layer Detector CT: A Novel Index Integrating Histopathological Differentiation and Ki-67"],"prefix":"10.1016","volume":"33","author":[{"given":"Mengru","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuai","family":"Ming","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wuyang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyu","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Shi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4097-1592","authenticated-orcid":false,"given":"Wei","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.acra.2026.01.044_bib1","first-page":"1970","article-title":"Presence of tumor deposits is an indicator of poor prognosis in patients with pancreatic ductal adenocarcinoma","volume":"13","author":"Liang","year":"2023","journal-title":"Am J Cancer Res"},{"issue":"4","key":"10.1016\/j.acra.2026.01.044_bib2","doi-asserted-by":"crossref","first-page":"1016","DOI":"10.1093\/annonc\/mdy033","article-title":"European cancer mortality predictions for the year 2018 with focus on colorectal cancer","volume":"29","author":"Malvezzi","year":"2018","journal-title":"Ann Oncol"},{"issue":"9","key":"10.1016\/j.acra.2026.01.044_bib3","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1001\/jama.2021.13027","article-title":"Pancreatic cancer: a review","volume":"326","author":"Park","year":"2021","journal-title":"JAMA"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib4","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1016\/j.ejso.2021.07.020","article-title":"Refined prognostic staging for resected pancreatic cancer by modified stage grouping and addition of tumour grade","volume":"48","author":"K\u00f6nig","year":"2022","journal-title":"Eur J Surg Oncol"},{"issue":"6","key":"10.1016\/j.acra.2026.01.044_bib5","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1038\/s41379-022-01055-1","article-title":"Ki-67 assessment of pancreatic neuroendocrine neoplasms: systematic review and meta-analysis of manual vs. digital pathology scoring","volume":"35","author":"Luchini","year":"2022","journal-title":"Mod Pathol"},{"issue":"9","key":"10.1016\/j.acra.2026.01.044_bib6","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1038\/s41379-019-0268-y","article-title":"Ki-67 is an independent predictor of prostate cancer death in routine needle biopsy samples: proving utility for routine assessments","volume":"32","author":"Kammerer-Jacquet","year":"2019","journal-title":"Mod Pathol"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib7","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1186\/s13244-024-01864-9","article-title":"Development and validation of a model based on preoperative dual-layer detector spectral computed tomography 3D VOI-based quantitative parameters to predict high Ki-67 proliferation index in pancreatic ductal adenocarcinoma","volume":"15","author":"Zeng","year":"2024","journal-title":"Insights Imaging"},{"issue":"8","key":"10.1016\/j.acra.2026.01.044_bib8","doi-asserted-by":"crossref","first-page":"4722","DOI":"10.1007\/s00330-025-11375-w","article-title":"Three-dimensional MR elastography-based stiffness for assessing the status of Ki67 proliferation index and Cytokeratin-19 in hepatocellular carcinoma","volume":"35","author":"Zhang","year":"2025","journal-title":"Eur Radiol"},{"issue":"10","key":"10.1016\/j.acra.2026.01.044_bib9","doi-asserted-by":"crossref","DOI":"10.4251\/wjgo.v17.i10.110570","article-title":"Contrast-enhanced ultrasound as a non-invasive diagnostic modality for pancreatic ductal adenocarcinoma: the question of Ki67 for study validation","volume":"17","author":"Moyana","year":"2025","journal-title":"World J Gastrointest Oncol"},{"issue":"5","key":"10.1016\/j.acra.2026.01.044_bib10","first-page":"416","article-title":"Prognostic significance of grade of malignancy based on histopathological differentiation and Ki-67 in pancreatic ductal adenocarcinoma","volume":"21","author":"Liang","year":"2024","journal-title":"Cancer Biol Med"},{"issue":"7","key":"10.1016\/j.acra.2026.01.044_bib11","doi-asserted-by":"crossref","first-page":"E380","DOI":"10.1055\/a-1541-7061","article-title":"Brisk bleeding after gastric lesion biopsy - possible needle tract seeding after endoscopic ultrasound-guided fine-needle biopsy of a pancreatic metastasis from renal cell carcinoma","volume":"54","author":"Freund","year":"2022","journal-title":"Endoscopy"},{"issue":"2","key":"10.1016\/j.acra.2026.01.044_bib12","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1053\/j.gastro.2022.03.056","article-title":"Pancreatic cancer: pathogenesis, screening, diagnosis, and treatment","volume":"163","author":"Wood","year":"2022","journal-title":"Gastroenterology"},{"issue":"7","key":"10.1016\/j.acra.2026.01.044_bib13","doi-asserted-by":"crossref","first-page":"E931","DOI":"10.1055\/a-0953-1640","article-title":"Fine-needle biopsy is superior to fine-needle aspiration of suspected gastrointestinal stromal tumors: a large multicenter study","volume":"7","author":"Trindade","year":"2019","journal-title":"Endosc Int Open"},{"key":"10.1016\/j.acra.2026.01.044_bib14","doi-asserted-by":"crossref","DOI":"10.1016\/j.ejrad.2021.109774","article-title":"Dual-energy CT in predicting Ki-67 expression in laryngeal squamous cell carcinoma","volume":"140","author":"Wang","year":"2021","journal-title":"Eur J Radiol"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib15","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s40644-020-00370-7","article-title":"Dual-energy CT quantitative parameters for evaluating immunohistochemical biomarkers of invasive breast cancer","volume":"21","author":"Wang","year":"2021","journal-title":"Cancer Imaging"},{"issue":"3","key":"10.1016\/j.acra.2026.01.044_bib16","doi-asserted-by":"crossref","first-page":"675","DOI":"10.1148\/radiol.2020200302","article-title":"Improved interobserver agreement on lung-RADS classification of solid nodules using semi-automated CT volumetry","volume":"297","author":"Gierada","year":"2020","journal-title":"Radiology"},{"issue":"5","key":"10.1016\/j.acra.2026.01.044_bib17","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.acra.2019.07.018","article-title":"A single enhanced dual-energy CT scan may distinguish lung squamous cell carcinoma from adenocarcinoma during the venous phase","volume":"27","author":"Zhang","year":"2020","journal-title":"Acad Radiol"},{"issue":"3","key":"10.1016\/j.acra.2026.01.044_bib18","doi-asserted-by":"crossref","DOI":"10.1016\/j.esmoop.2021.100119","article-title":"Capecitabine plus temozolomide in patients with grade 3 unresectable or metastatic gastroenteropancreatic neuroendocrine neoplasms with Ki-67 index <55%: single-arm phase II study","volume":"6","author":"Jeong","year":"2021","journal-title":"ESMO Open"},{"issue":"6","key":"10.1016\/j.acra.2026.01.044_bib19","doi-asserted-by":"crossref","first-page":"1221","DOI":"10.2214\/AJR.18.19791","article-title":"Assessing chemotherapeutic response in pancreatic ductal adenocarcinoma: histogram analysis of iodine concentration and CT number in single-source dual-energy CT","volume":"211","author":"Noda","year":"2018","journal-title":"AJR Am J Roentgenol"},{"key":"10.1016\/j.acra.2026.01.044_bib20","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/RLI.0000000000000724","article-title":"Intraindividual consistency of iodine concentration in dual-energy computed tomography of the chest and abdomen","volume":"56","author":"Zopfs","year":"2021","journal-title":"Invest Radiol"},{"issue":"5","key":"10.1016\/j.acra.2026.01.044_bib21","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.acra.2019.07.018","article-title":"A single enhanced dual-energy CT scan may distinguish lung squamous cell carcinoma from adenocarcinoma during the venous phase","volume":"27","author":"Zhang","year":"2020","journal-title":"Acad Radiol"},{"issue":"31","key":"10.1016\/j.acra.2026.01.044_bib22","article-title":"Application of dual-energy computed tomography in preoperative evaluation of Ki-67 expression levels in solid non-small cell lung cancer","volume":"101","author":"Tian","year":"2022","journal-title":"Medicine ((Baltimore))"},{"key":"10.1016\/j.acra.2026.01.044_bib23","doi-asserted-by":"crossref","DOI":"10.3389\/fonc.2022.1040411","article-title":"Development and validation of a nomogram to predict liver metastasis for pancreatic ductal adenocarcinoma after radical resection","volume":"12","author":"Tong","year":"2022","journal-title":"Front Oncol"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1186\/s13244-023-01376-y","article-title":"Reproducibility of 2D versus 3D radiomics for quantitative assessment of fetal lung development: a retrospective fetal MRI study","volume":"14","author":"Watzenboeck","year":"2023","journal-title":"Insights Imaging"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib25","doi-asserted-by":"crossref","DOI":"10.1142\/S0129065722500599","article-title":"Mixture 2D convolutions for 3D medical image segmentation","volume":"33","author":"Wang","year":"2023","journal-title":"Int J Neural Syst"},{"issue":"5","key":"10.1016\/j.acra.2026.01.044_bib26","doi-asserted-by":"crossref","first-page":"5943","DOI":"10.18632\/oncotarget.6819","article-title":"Serum CA125 is a novel predictive marker for pancreatic cancer metastasis and correlates with the metastasis-associated burden","volume":"7","author":"Liu","year":"2016","journal-title":"Oncotarget"},{"issue":"1","key":"10.1016\/j.acra.2026.01.044_bib27","first-page":"7","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J Clin"}],"container-title":["Academic Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1076633226000735?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1076633226000735?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T11:47:48Z","timestamp":1778759268000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1076633226000735"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":27,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S1076633226000735"],"URL":"https:\/\/doi.org\/10.1016\/j.acra.2026.01.044","relation":{},"ISSN":["1076-6332"],"issn-type":[{"value":"1076-6332","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Noninvasive Prediction of Tumor Malignancy Grade in Pancreatic Ductal Adenocarcinoma with Dual-Layer Detector CT: A Novel Index Integrating Histopathological Differentiation and Ki-67","name":"articletitle","label":"Article Title"},{"value":"Academic Radiology","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.acra.2026.01.044","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Association of Academic Radiology. Published by Elsevier Inc.","name":"copyright","label":"Copyright"}]}}