Optimizing Portal Venous Phase Acquisition Quality of Contrast-Enhanced CT in Oncology

Background: Portal venous phase (PVP) contrast-enhanced CT is a cornerstone for response assessment in early-phase oncology trials, yet contrast-enhancement phase timing remains insufficiently monitored across sites. We assessed PVP timing using a validated artificial intelligence (AI) quality control tool (CECT-QC). Methods: In this retrospective multicenter study, 402 CT examinations from 402 patients enrolled in phase I oncology trials across three European institutions were analyzed using CECT-QC, which quan…

By the Truvace deskOctober 17, 20262 min read1 sourcePeer-reviewedTRV-2026-1699· cite & verify

Optimizing Portal Venous Phase Acquisition Quality of Contrast-Enhanced CT in Oncology — "McArdle Laboratory for Cancer Research" by wackybadger is licensed under CC BY-SA 2.0. To view a copy of this license, visit https://creativecommons.org/licenses/by-sa/2.0/.

In brief

Researchers applied a validated AI tool, CECT-QC, to 402 CT examinations from patients in phase I oncology trials at three European institutions. The tool measures enhancement in the aorta and portal vein to judge whether the contrast phase was optimal. In the 335 standard CT scans of the primary analysis, just over half were rated optimal.

Consistent contrast timing matters because CT is used to assess how tumors respond to treatment in early-phase trials. The findings show that timing quality is uneven between sites and scanner platforms, which could affect comparability of trial imaging. The study is retrospective and the classifier may need adaptation for newer scanners, so the results point to monitoring needs rather than proven fixes.

Main points

Optimal portal venous phase rates were 39.0% at Institution A, 56.9% at Institution B, and 59.0% at Institution C.
A French regulatory change affecting contrast delivery showed no significant association with optimal classification (p = 0.716).
At Institution A, standard CT had higher odds of optimal classification than photon-counting CT (OR 2.24).
Photon-counting CT showed higher aortic and portal venous attenuation than standard CT (both p < 0.001).

The problem

An AI quality-control tool classified only 53.1% of standard CT examinations in phase I oncology trials as optimal portal venous phase, with significant variation across institutions and scanner types.

The rundown

The retrospective multicenter study analyzed one CT examination from each of 402 patients enrolled in phase I oncology trials. The primary analysis covered 335 standard CT scans, with the remainder involving photon-counting CT.

Comparisons covered institutions, the period before versus after French regulatory changes affecting contrast delivery, and scanner technology. Institutional differences remained significant after adjustment (p = 0.039), while the legislative change showed no significant effect.

The authors conclude that continued quality-control monitoring, protocol harmonization, and adapting classification tools to emerging CT platforms are warranted.