肿瘤切除后胰腺癌（PDAC）的预后仍然很差，主要是由于复发风险高但可变。 CT 肿瘤增强的量化是改善预后的一个有前途的工具。为此，之前的研究中已经使用了各种增强公式。然而，缺乏对这些公式的系统比较。在本研究中，我们将 23 种先前发表的 CT 增强公式应用于 92 名接受前期手术的 PDAC 患者。我们确定了七个可以可靠预测肿瘤复发的公式。使用这些公式，肿瘤增强较弱与术后一年和两年的肿瘤复发相关（p≤≤0.030）。增强与不良临床病理特征呈负相关。低增强值预示着高复发风险（风险比 ≥ 1.659，p ≤ 0.028，Cox回归）和短的复发时间（TTR）（p ≤ 0.027，对数秩检验）。一些公式是多变量模型中 TTR 的独立预测因子。引人注目的是，几乎所有效果最好的公式都只测量肿瘤组织，这表明可能没有必要对非肿瘤结构进行标准化。表现最好的还有绝对动脉/门静脉肿瘤衰减值。这些可以在临床实践中轻松实施，以更好地预测复发，从而有可能改善患者管理。© 2024。作者。

The prognosis of pancreatic cancer (PDAC) after tumor resection remains poor, mostly due to a high but variable risk of recurrence. A promising tool for improved prognostication is the quantification of CT tumor enhancement. For this, various enhancement formulas have been used in previous studies. However, a systematic comparison of these formulas is lacking. In the present study, we applied twenty-three previously published CT enhancement formulas to our cohort of 92 PDAC patients who underwent upfront surgery. We identified seven formulas that could reliably predict tumor recurrence. Using these formulas, weak tumor enhancement was associated with tumor recurrence at one and two years after surgery (p ≤ 0.030). Enhancement was inversely associated with adverse clinicopathological features. Low enhancement values were predictive of a high recurrence risk (Hazard Ratio ≥ 1.659, p ≤ 0.028, Cox regression) and a short time to recurrence (TTR) (p ≤ 0.027, log-rank test). Some formulas were independent predictors of TTR in multivariate models. Strikingly, almost all of the best-performing formulas measure solely tumor tissue, suggesting that normalization to non-tumor structures might be unnecessary. Among the top performers were also the absolute arterial/portal venous tumor attenuation values. These can be easily implemented in clinical practice for better recurrence prediction, thus potentially improving patient management.© 2024. The Author(s).