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Wang T, Li B, Shi H, Li P, Deng Y, Wang S, Luo Q, Xv D, He J, Wang S. Short-term PET-derived kinetic estimation for the diagnosis of hepatocellular carcinoma: a combination of the maximum-slope method and dual-input three-compartment model. Insights Imaging 2023; 14:98. [PMID: 37226012 DOI: 10.1186/s13244-023-01442-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 04/24/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Kinetic estimation provides fitted parameters related to blood flow perfusion and fluorine-18-fluorodeoxyglucose (18F-FDG) transport and intracellular metabolism to characterize hepatocellular carcinoma (HCC) but usually requires 60 min or more for dynamic PET, which is time-consuming and impractical in a busy clinical setting and has poor patient tolerance. METHODS This study preliminarily evaluated the equivalence of liver kinetic estimation between short-term (5-min dynamic data supplemented with 1-min static data at 60 min postinjection) and fully 60-min dynamic protocols and whether short-term 18F-FDG PET-derived kinetic parameters using a three-compartment model can be used to discriminate HCC from the background liver tissue. Then, we proposed a combined model, a combination of the maximum-slope method and a three-compartment model, to improve kinetic estimation. RESULTS There is a strong correlation between the kinetic parameters K1 ~ k3, HPI and [Formula: see text] in the short-term and fully dynamic protocols. With the three-compartment model, HCCs were found to have higher k2, HPI and k3 values than background liver tissues, while K1, k4 and [Formula: see text] values were not significantly different between HCCs and background liver tissues. With the combined model, HCCs were found to have higher HPI, K1 and k2, k3 and [Formula: see text] values than background liver tissues; however, the k4 value was not significantly different between HCCs and the background liver tissues. CONCLUSIONS Short-term PET is closely equivalent to fully dynamic PET for liver kinetic estimation. Short-term PET-derived kinetic parameters can be used to distinguish HCC from background liver tissue, and the combined model improves the kinetic estimation. CLINICAL RELEVANCE STATEMENT Short-term PET could be used for hepatic kinetic parameter estimation. The combined model could improve the estimation of liver kinetic parameters.
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Affiliation(s)
- Tao Wang
- Yunnan Key Laboratory of Artificial Intelligence, Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, 650500, Yunnan, China
| | - Boqiao Li
- Yunnan Key Laboratory of Artificial Intelligence, Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, 650500, Yunnan, China
| | - Hong Shi
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China
| | - Pengfei Li
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China
| | - Yinglei Deng
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China
| | - Siyu Wang
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China
| | - Qiao Luo
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China
| | - Dongdong Xv
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China
| | - Jianfeng He
- Yunnan Key Laboratory of Artificial Intelligence, Faculty of Information Engineering and Automation, Kunming University of Science and Technology, Kunming, 650500, Yunnan, China.
| | - Shaobo Wang
- PET/CT Center, Affiliated Hospital of Kunming University of Science and Technology, First People's Hospital of Yunnan, Kunming, 650031, China.
- Yunnan Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, China.
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Pan K, Wang H, Chen X, Ye X, Zhang Z, Chen X, Jia X. Comparative analysis of two mathematical algorithms for the calculation of computed tomography perfusion parameters in the healthy and diseased pancreas. J Appl Clin Med Phys 2021; 23:e13488. [PMID: 34897951 PMCID: PMC8833275 DOI: 10.1002/acm2.13488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/08/2021] [Accepted: 11/15/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The maximum slope (MS) and deconvolution (DC) algorithms are commonly used to post-process computed tomography perfusion (CTP) data. This study aims to analyze the differences between MS and DC algorithms for the calculation of pancreatic CTP parameters. METHODS The pancreatic CTP data of 57 patients were analyzed using MS and DC algorithms. Two blinded radiologists calculated pancreatic blood volume (BV) and blood flow (BF). Interobserver correlation coefficients were used to evaluate the consistency between two radiologists. Paired t-tests, Pearson linear correlation analysis, and Bland-Altman analysis were performed to evaluate the correlation and consistency of the CTP parameters between the two algorithms. RESULTS Among the 30 subjects with normal pancreas, the BV values in the three pancreatic regions were higher in the case of the MS algorithm than in the case of the DC algorithm (t = 39.35, p < 0.001), and the BF values in the three pancreatic regions were slightly higher for the MS algorithm than for the DC algorithm (t = 2.19, p = 0.031). Similarly, among the 27 patients with acute pancreatitis, the BV values obtained using the MS methods were higher than those obtained using the DC methods (t = 54.14, p < 0.001). Furthermore, the BF values were higher with the MS methods than the DC methods (t = 8.45, p < 0.001). Besides, Pearson linear correlation and Bland-Altman analysis showed that the BF and BV values showed a good correlation and a bad consistency between the two algorithms. CONCLUSIONS The BF and BV values measured using MS and DC algorithms had a good correlation but were not consistent.
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Affiliation(s)
- Kehua Pan
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hongqing Wang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyu Chen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiaocui Ye
- Department of Ultrasonics, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhao Zhang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiao Chen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiufen Jia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Choi JW, Cho HR, Lee K, Jung JK, Kim HC. Modified Rat Hepatocellular Carcinoma Models Overexpressing Vascular Endothelial Growth Factor. J Vasc Interv Radiol 2018; 29:1604-1612. [PMID: 30293733 DOI: 10.1016/j.jvir.2018.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2017] [Revised: 06/21/2018] [Accepted: 07/05/2018] [Indexed: 10/28/2022] Open
Abstract
PURPOSE To compare tumor vascularity in 4 types of rat hepatocellular carcinoma (HCC) models: N1S1, vascular endothelial growth factor (VEGF)-transfected N1S1 (VEGF-N1S1), McA-RH7777, and VEGF-transfected McA-RH7777 (VEGF-McA-RH777) tumors. MATERIALS AND METHODS The N1S1 and McA-RH7777 cell lines were transfected with expression vectors containing cDNA for rat VEGF. Eighty-eight male Sprague-Dawley rats (weight range, 400-450 g) were randomly divided into 4 groups (ie, 22 rats per model), and 4 types of tumor models were created by using the N1S1, VEGF-N1S1, McA-RH7777, and VEGF-McA-RH777 cell lines. Tumor vascularity was evaluated by perfusion computed tomography (CT), enzyme-linked immunosorbent assay of VEGF, CD34 staining, angiography, and Lipiodol transarterial embolization. Intergroup discrepancies were evaluated by Kruskal-Wallis test. RESULTS Arterial perfusion (P < .001), portal perfusion (P = .015), total perfusion (P < .001), tumor VEGF level (P = .002), and microvessel density (MVD; P = .007) were significantly different among groups. VEGF-McA-RH7777 tumors showed the greatest arterial perfusion (46.7 mL/min/100 mL ± 15.5), total perfusion (60.7 mL/min/100 mL ± 21.8), tumor VEGF level (3,376.7 pg/mL ± 145.8), and MVD (34.5‰ ± 7.5). Whereas most tumors in the N1S1, VEGF-N1S1, and McA-RH7777 groups showed hypovascular staining on angiography and minimal Lipiodol uptake after embolization, 5 of 6 VEGF-McA-RH7777 tumors (83.3%) presented hypervascular tumor staining and moderate to compact Lipiodol uptake. CONCLUSIONS McA-RH7777 tumors were more hypervascular than N1S1 tumors, and tumor vascularity was enhanced further by VEGF transfection. Therefore, the VEGF-McA-RH7777 tumor is recommended to mimic hypervascular human HCC in rats.
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Affiliation(s)
- Jin Woo Choi
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Hye Rim Cho
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Kyoungbun Lee
- Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Jae Kyung Jung
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea
| | - Hyo-Cheol Kim
- Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Korea.
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Komatsu D, Yamada A, Suzuki T, Kurozumi M, Fujinaga Y, Ueda K, Kadoya M. Compartment model analysis of intravenous contrast-enhanced dynamic computed tomography in hepatic hemodynamics: A validation study using intra-arterial contrast-enhanced computed tomography. Hepatol Res 2018; 48:829-838. [PMID: 29476594 DOI: 10.1111/hepr.13073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 01/24/2023]
Abstract
AIM To verify the utility of the 2-in-1-out-compartment model analysis (CMA) of intravenous contrast-enhanced dynamic computed tomography (IV-CT) for evaluating hepatic arterial and portal venous flow using intra-arterial contrast-enhanced CT (IA-CT). METHODS We retrospectively evaluated 49 consecutive patients who underwent IV-CT and were radiologically or histologically diagnosed as having hepatic malignant lesion (51 classical hepatocellular carcinomas [HCC], 4 early HCC, 3 cholangiolocellular carcinomas, 1 mixed HCC, 3 cholangiocellular carcinomas). As a gold standard for hepatic arterial and portal blood flows, we defined the normalized enhancement in CT values on CTAP (nCTAP) and CTHA (nCTHA). The hepatic arterial (k1a ) and portal venous inflow velocity (k1p ) constants in hepatic lesions and surrounding liver parenchyma were obtained from the CMA of IV-CT with various outflow velocity constant (k2 ) limits using the nonlinear least square method. The correlation coefficient between the normalized enhancement in IA-CT and CMA of IV-CT was statistically evaluated according to various k2 limits. RESULTS The highest mean correlation coefficient between k1a and nCTHA (r = 0.65, P < 0.0001) was observed when k2 ≦0.035. The highest mean correlation coefficient between k1p and nCTAP (r = 0.69, P < 0.0001) was observed when k2 ≦0.045. The decrease in correlation coefficient was significant when the upper k2 limit was lower than 0.03 or higher than 0.07 compared to the best mean correlation coefficient (P < 0.05). CONCLUSION Hepatic arterial and portal venous flows can be evaluated quantitatively to some extent with appropriate outflow velocity constant limits using the CMA of IV-CT.
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Affiliation(s)
- Daisuke Komatsu
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Akira Yamada
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Takeshi Suzuki
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Masahiro Kurozumi
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Yasunari Fujinaga
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
| | - Kazuhiko Ueda
- Diagnostic Imaging Center, The Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Masumi Kadoya
- Department of Radiology, Shinshu University School of Medicine, Nagano, Tokyo, Japan
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Fischer MA, Marquez HP, Gordic S, Leidner B, Klotz E, Aspelin P, Alkadhi H, Brismar TB. Arterio-portal shunts in the cirrhotic liver: perfusion computed tomography for distinction of arterialized pseudolesions from hepatocellular carcinoma. Eur Radiol 2016; 27:1074-1080. [PMID: 27368924 DOI: 10.1007/s00330-016-4432-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 02/24/2016] [Accepted: 05/20/2016] [Indexed: 02/08/2023]
Abstract
OBJECTIVES To determine perfusion computed tomography (P-CT) findings for distinction of arterial pseudolesions (APL) from hepatocellular carcinoma (HCC) in the cirrhotic liver. METHODS 32 APL and 21 HCC in 20 cirrhotic patients (15 men; 65 ± 10 years), who underwent P-CT for evaluation of HCC pre- (N = 9) or post- (N = 11) transarterial chemoembolization, were retrospectively included using CT follow-up as the standard of reference. All 53 lesions were qualitatively (visual) and quantitatively (perfusion parameters) analysed according to their shape (wedge, irregular, nodular), location (not-/adjunct to a fistula), arterial liver perfusion (ALP), portal venous liver perfusion (PLP), hepatic perfusion index (HPI). Accuracy for diagnosis of HCC was determined using receiver operating characteristics. RESULTS 18/32 (56 %) APL were wedge shaped, 10/32 (31 %) irregular and 4/32 (12 %) nodular, while 11/21 (52 %) HCC were nodular or 10/21 (48 %) irregular, but never wedge shaped. Significant difference between APL and HCC was seen for lesion shape in pretreated lesions (P < 0.001), and for PLP and HPI in both pre- and post-treated lesions (all, P < 0.001). Diagnostic accuracy for HCC was best for combined assessment of lesion configuration and PLP showing an area under the curve of 0.901. CONCLUSION Combined assessment of lesion configuration and portal venous perfusion derived from P-CT allows best to discriminate APL from HCC with high diagnostic accuracy. KEY POINTS • Arterio-portal shunting is common in the cirrhotic liver, especially after local treatment. • Arterial pseudolesions (APL) due to shunting might mimic hepatocellular carcinoma (HCC). • Perfusion-CT allows for qualitative and quantitative assessment of liver lesions. • Lesion configuration fails to discriminate APL from HCC in locally treated patients. • Integration of quantitative perfusion analysis improves accuracy for diagnosis of HCC.
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Affiliation(s)
- Michael A Fischer
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, CH-8091, Zurich, Switzerland. .,Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-14186, Stockholm, Sweden.
| | - Herman P Marquez
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, CH-8091, Zurich, Switzerland
| | - Sonja Gordic
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, CH-8091, Zurich, Switzerland
| | - Bertil Leidner
- Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-14186, Stockholm, Sweden
| | - Ernst Klotz
- Siemens Healthcare, Computed Tomography and Radiation Oncology, DE-91301, Forchheim, Germany
| | - Peter Aspelin
- Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-14186, Stockholm, Sweden
| | - Hatem Alkadhi
- Department of Diagnostic and Interventional Radiology, University Hospital Zurich, CH-8091, Zurich, Switzerland
| | - Torkel B Brismar
- Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, SE-14186, Stockholm, Sweden
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Romano M, D’Antò M, Bifulco P, Fiore F, Cesarelli M. Robustness to noise of arterial blood flow estimation methods in CT perfusion. BMC Res Notes 2014; 7:540. [PMID: 25130498 PMCID: PMC4152598 DOI: 10.1186/1756-0500-7-540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 08/01/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Perfusion CT is a technology which allows functional evaluation of tissue vascularity. Due to this potential, it is finding increasing utility in oncology. Although since its introduction continuous advances have interested CT technique, some issues have to be still defined, concerning both clinical and technical aspects. In this study, we dealt with the comparison of two widely employed mathematical models (dual input one compartment model - DOCM - and maximum slope - SM -) analyzing their robustness to the noise. METHODS We carried out a computer simulation process to quantify effect of noise on the evaluation of an important perfusion parameter (Arterial Blood Flow - BFa) in liver tumours. A total of 4500 liver TAC, corresponding to 3 fixed BFa values, were simulated using different arterial and portal TAC (computed from 5 real CT images) at 10 values of signal to noise ratio (SNR). BFa values were calculated by applying four different algorithms, specifically developed, to these noisy simulated curves. Three algorithms were developed to implement SM (one semiautomatic, one automatic and one automatic with filtering) and the last for the DOCM method. RESULTS In all the simulations, DOCM provided the best results, i.e., those with the lowest percentage error compared to the reference value of BFa. Concerning SM, the results are variable. Results obtained with the automatic algorithm with filtering are close to the reference value, but only if SNR is higher than 50. Vice versa, results obtained by means of the semiautomatic algorithm gave, in all simulations, the lowest results with the lowest standard deviation of the percentage error. CONCLUSIONS Since the use of DOCM is limited by the necessity that portal vein is visible in CT scans, significant restriction for patients' follow-up, we concluded that SM can be reliably employed. However, a proper software has to be used and an estimation of SNR would be carried out.
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Affiliation(s)
- Maria Romano
- />DIETI, University of Naples, “Federico II”, Naples, Italy
- />Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Rome, Italy
| | - Michela D’Antò
- />DIETI, University of Naples, “Federico II”, Naples, Italy
- />National Cancer Institute “Pascale Foundation”, Naples, Italy
| | - Paolo Bifulco
- />DIETI, University of Naples, “Federico II”, Naples, Italy
- />Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Rome, Italy
| | - Francesco Fiore
- />National Cancer Institute “Pascale Foundation”, Naples, Italy
| | - Mario Cesarelli
- />DIETI, University of Naples, “Federico II”, Naples, Italy
- />Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Rome, Italy
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Wang X, Qiao ZW, Zhou ZJ, Zhuang PJ, Zheng S. Postoperative morphine concentration in infants with or without biliary atresia and its association with hepatic blood flow. Anaesthesia 2014; 69:583-90. [PMID: 24749886 DOI: 10.1111/anae.12624] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- X. Wang
- Department of Anesthesiology; Children's Hospital of Fudan University; Shanghai China
| | - Z. W. Qiao
- Department of Radiology; Children's Hospital of Fudan University; Shanghai China
| | - Z. J. Zhou
- Department of Anesthesiology; Children's Hospital of Fudan University; Shanghai China
| | - P. J. Zhuang
- Department of Anesthesiology; Children's Hospital of Fudan University; Shanghai China
| | - S. Zheng
- Department of Surgery; Children's Hospital of Fudan University; Shanghai China
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Zhao LQ, He W, Yan B, Wang HY, Wang J. The evaluation of haemodynamics in cirrhotic patients with spectral CT. Br J Radiol 2013; 86:20130228. [PMID: 23881800 DOI: 10.1259/bjr.20130228] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate haemodynamics in cirrhotic patients with portal hypertension using spectral CT imaging. METHODS 118 cirrhotic patients with portal hypertension were included in the study group (further divided into Child-Pugh A, B and C subgroups). The control group consisted of 21 subjects with normal liver functionality. All subjects underwent three-phase spectral CT scans. Material decomposition images with water and iodine as basis material pairs were reconstructed. The iodine concentrations for the hepatic parenchyma in both arterial and portal venous phases were measured. The arterial iodine fraction (AIF) was obtained by dividing the iodine concentration in the hepatic arterial phase by that in the portal venous phase. AIF values from the study and control groups were compared using analysis of variance and between subgroups using a post-hoc test with Bonferroni correction, with a statistical significance of p<0.05. RESULTS The AIF was 0.25±0.05 in the control group, and 0.29±0.10, 0.37±0.12 and 0.43±0.14 in the study group with Child-Pugh Grades A, B and C, respectively. The difference in AIF between the control and study groups was statistically significant. The differences were statistically significant between the subgroups with multiple comparisons except between the control group and the Child-Pugh A group (p=0.685). CONCLUSION AIF measured in spectral CT could be used to evaluate the liver haemodynamics of cirrhotic patients. ADVANCES IN KNOWLEDGE The AIF, provided by spectral CT, could be used as a new parameter to observe liver haemodynamics.
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Affiliation(s)
- L-Q Zhao
- Department of Radiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing, China
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Watanabe S, Katada Y, Gohkyu M, Nakajima M, Kawabata H, Nozaki M. Liver perfusion CT during hepatic arteriography for the hepatocellular carcinoma: Dose reduction and quantitative evaluation for normal- and ultralow-dose protocol. Eur J Radiol 2012; 81:3993-7. [DOI: 10.1016/j.ejrad.2012.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 08/01/2012] [Accepted: 08/15/2012] [Indexed: 01/04/2023]
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Katada Y, Shukuya T, Kawashima M, Nozaki M, Imai H, Natori T, Tamano M. A comparative study between arterial spin labeling and CT perfusion methods on hepatic portal venous flow. Jpn J Radiol 2012; 30:863-9. [PMID: 22986750 DOI: 10.1007/s11604-012-0127-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2012] [Accepted: 08/20/2012] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the feasibility and potential usefulness of unenhanced magnetic resonance (MR) hepatic portal perfusion using arterial spin labeling (ASL) among healthy volunteers and hepatocellular carcinoma patients. MATERIALS AND METHODS The five healthy volunteers underwent unenhanced MR perfusion with inversion time 2 (TI2) values at 500-ms intervals between 2,000 and 4,000 ms, and the 12 patients underwent unenhanced MR perfusion using ASL and computed tomography (CT) perfusion during superior mesenteric artery (SMA) portography. The regions of interest were placed in both the right and left lobes of the liver or both the right anterior and posterior segments of the liver and were placed over the tumor if a lesion was located within a particular perfusion study slice. RESULTS In the healthy volunteer study, perfusion rate in hepatic parenchyma showed a peak at the TI2 value of 3,000 ms (254.3 ml/min/100 g ± 58.3). In patients, a fair correlation was observed between CT and MR perfusion (r = 0.795, P < 0.01). CONCLUSION Our results demonstrate a significant fair correlation between unenhanced MR hepatic portal perfusion imaging using ASL and CT perfusion during SMA portography.
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Affiliation(s)
- Yoshiaki Katada
- Department of Radiology, Dokkyo Medical University Koshigaya Hospital, 2-1-50, Minami-Koshigaya, Koshigaya, Saitama 343-8555, Japan.
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Shibuya K, Tsushima Y, Horisoko E, Noda SE, Taketomi-Takahashi A, Ohno T, Amanuma M, Endo K, Nakano T. Blood flow change quantification in cervical cancer before and during radiation therapy using perfusion CT. JOURNAL OF RADIATION RESEARCH 2011; 52:804-811. [PMID: 21959830 DOI: 10.1269/jrr.11079] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to quantify the changes of tumor blood flow (BF) in cervical cancer after radiation therapy by using perfusion computed tomography (CT), and to examine the difference between maximum slope (MS) and single-input one-compartment model (SOCM) methods. Fourteen consecutive patients who received definitive radiation therapy for cervical cancer from October 2009 to February 2010 were enrolled in this study. Blood flow (BF) analyses were performed using both MS and SOCM methods. Quantitative BF maps were created using Body Perfusion (Toshiba Medical Systems, Co. Tokyo, Japan). Perfusion color maps were successfully created by the two analytical methods. BF of the tumors was clearly higher than that of normal cervix, making it possible to distinguish tumor tissue from normal cervical tissue. BF of the tumors after 20 Gy of radiation therapy calculated by the MS method was significantly larger than that before treatment (126.9 vs. 72.2 ml/min/100 ml, median; p < 0.05). Although BF calculated by the MS and SOCM methods showed a positive linear correlation (p < 0.001, r = 0.981), BF calculated by the MS method was lower than that obtained by the SOCM method (103.7 vs. 115.1 ml/min/100 ml, p < 0.01). The change of tumor BF in cervical cancer before and after radiation therapy can be monitored by conducting blood flow analysis using perfusion CT. BF by the MS method was lower than that by the SOCM method, but the two analytical methods correlated well. Perfusion CT may have potential in noninvasive monitoring of vascular and oxygenation status and for guiding adaptive therapy.
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Affiliation(s)
- Kei Shibuya
- Department of Radiation Oncology, Gunma University Graduate school of Medicine, Maebashi, Gunma 371-8511, Japan.
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Kanda T, Yoshikawa T, Ohno Y, Kanata N, Koyama H, Takenaka D, Sugimura K. CT hepatic perfusion measurement: comparison of three analytic methods. Eur J Radiol 2011; 81:2075-9. [PMID: 21802233 DOI: 10.1016/j.ejrad.2011.07.003] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2011] [Revised: 07/03/2011] [Accepted: 07/05/2011] [Indexed: 12/27/2022]
Abstract
OBJECTIVES To compare the efficacy of three analytic methods, maximum slope (MS), dual-input single-compartment model (CM) and deconvolution (DC), for CT measurements of hepatic perfusion and assess the effects of extra-hepatic systemic factors. MATERIALS AND METHODS Eighty-eight patients who were suspected of having metastatic liver tumors underwent hepatic CT perfusion. The scans were performed at the hepatic hilum 7-77 s after administration of contrast material. Hepatic arterial and portal perfusions (HAP and HPP, ml/min/100 ml) and arterial perfusion fraction (APF, %) were calculated with the three methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors such as age, sex, risk of cardiovascular diseases, arrival time of contrast material at abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction. RESULTS Mean HAP of MS was significantly higher than DC. HPP of CM was significantly higher than MS and CM, and HPP of MS was significantly higher than DC. There was no significant difference in APF. HAP and APF showed significant and moderate correlations among the methods. HPP showed significant and moderate correlations between CM and DC, and poor correlation between MS and CM or DC. All methods showed weak correlations between HAP or APF and age or sex. Finally, MS showed weak correlations between HAP or HPP and arrival time or cardiovascular risks. CONCLUSIONS Hepatic perfusion values arrived at with the three methods are not interchangeable. CM and DC are less susceptible to extra-hepatic systemic factors.
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Affiliation(s)
- Tomonori Kanda
- Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017, Japan
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Abstract
OBJECTIVE The objective of this study was to demonstrate the feasibility of pancreatic perfusion computed tomography (CT) and review pancreatic perfusion measurements by various imaging modalities. METHODS Dynamic CT data from 8 patients (4 men; mean age, 64.8 [SD, 12.1] years; range, 40-80 years) with normal pancreas were analyzed using 2 analytical models: the maximum-slope and compartment-model methods. Literature search was also performed. RESULTS Although the perfusion value estimated by the maximum-slope method (88.1 [SD, 42.1] mL/min per 100 mL) was significantly smaller than that of the compartment-model method (127.0 [SD, 70.5]; P < 0.001), there was a linear correlation between them (r = 0.97, P < 0.001). In the literature review, 15 studies that reported the absolute values of normal pancreatic perfusion, by using perfusion CT, dynamic magnetic resonance imaging, hydrogen gas clearance method, and 15O-H2O-positron emission tomography were found. The reported mean values of normal pancreatic perfusion ranged from 38.4 to 356 mL/min per 100 mL, and there was a great deal of individual variation. CONCLUSIONS Perfusion CT may provide reliable perfusion measurements of the pancreas, and the normal value was estimated at around 100 mL/min per 100 mL with a great deal of individual variation. The maximum-slope method may provide a lower perfusion value compared with the compartment-model method.
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14
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Koh DM, Padhani AR. Functional magnetic resonance imaging of the liver: parametric assessments beyond morphology. Magn Reson Imaging Clin N Am 2011; 18:565-85, xii. [PMID: 21094456 DOI: 10.1016/j.mric.2010.07.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
There is growing interest in exploring and using functional imaging techniques to provide additional information on structural alterations in the liver, which often occur late in the disease process. This article presents a summary of the different functional MR imaging techniques currently in use, focusing on dynamic contrast-enhanced MR imaging, diffusion-weighted MR imaging, MR spectroscopy, in- and oppose-phase MR imaging, and T2*-weighted imaging. For each technique, the biologic underpinning for the technique is explained, the clinical applications surveyed, and the challenges for their application enumerated. Developing and less frequently used techniques such as MR elastography, blood oxygenation level dependent imaging, dynamic susceptibility contrast-enhanced MR imaging, and diffusion-tensor imaging are reviewed. The challenges widespread adoption of functional MR imaging and the translation of such techniques to high field strengths are also discussed.
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Affiliation(s)
- Dow-Mu Koh
- Department of Radiology, Royal Marsden Hospital, Downs Road, Sutton SM2 5PT, UK.
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15
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Li JP, Zhao DL, Jiang HJ, Huang YH, Li DQ, Wan Y, Liu XD, Wang JE. Assessment of tumor vascularization with functional computed tomography perfusion imaging in patients with cirrhotic liver disease. Hepatobiliary Pancreat Dis Int 2011; 10:43-9. [PMID: 21269934 DOI: 10.1016/s1499-3872(11)60006-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) is a common malignant tumor in China, and early diagnosis is critical for patient outcome. In patients with HCC, it is mostly based on liver cirrhosis, developing from benign regenerative nodules and dysplastic nodules to HCC lesions, and a better understanding of its vascular supply and the hemodynamic changes may lead to early tumor detection. Angiogenesis is essential for the growth of primary and metastatic tumors due to changes in vascular perfusion, blood volume and permeability. These hemodynamic and physiological properties can be measured serially using functional computed tomography perfusion (CTP) imaging and can be used to assess the growth of HCC. This study aimed to clarify the physiological characteristics of tumor angiogenesis in cirrhotic liver disease by this fast imaging method. METHODS CTP was performed in 30 volunteers without liver disease (control subjects) and 49 patients with liver disease (experimental subjects: 27 with HCC and 22 with cirrhosis). All subjects were also evaluated by physical examination, laboratory screening and Doppler ultrasonography of the liver. The diagnosis of HCC was made according to the EASL criteria. All patients underwent contrast-enhanced ultrasonography, pre- and post-contrast triple-phase CT and CTP study. A mathematical deconvolution model was applied to provide hepatic blood flow (HBF), hepatic blood volume (HBV), mean transit time (MTT), permeability of capillary vessel surface (PS), hepatic arterial index (HAI), hepatic arterial perfusion (HAP) and hepatic portal perfusion (HPP) data. The Mann-Whitney U test was used to determine differences in perfusion parameters between the background cirrhotic liver parenchyma and HCC and between the cirrhotic liver parenchyma with HCC and that without HCC. RESULTS In normal liver, the HAP/HVP ratio was about 1/4. HCC had significantly higher HAP and HAI and lower HPP than background liver parenchyma adjacent to the HCC. The value of HBF at the tumor rim was significantly higher than that in the controls. HBF, HBV, HAI, HAP and HPP, but not MTT and PS, were significantly higher in the cirrhotic liver parenchyma involved with HCC than those of the controls. Perfusion parameters were not significantly different between the controls and the cirrhotic liver parenchyma not involved with HCC. CONCLUSIONS CTP can clearly distinguish tumor from cirrhotic liver parenchyma and controls and can provide quantitative information about tumor-related angiogenesis, which can be used to assess tumor vascularization in cirrhotic liver disease.
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Affiliation(s)
- Jin-Ping Li
- Department of Radiology, Second Affiliated Hospital, Harbin Medical University, Harbin 150086, China
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Kanda T, Yoshikawa T, Ohno Y, Kanata N, Koyama H, Nogami M, Takenaka D, Sugimura K. Hepatic computed tomography perfusion: comparison of maximum slope and dual-input single-compartment methods. Jpn J Radiol 2010; 28:714-9. [DOI: 10.1007/s11604-010-0497-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Accepted: 07/19/2010] [Indexed: 10/18/2022]
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17
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Perfusion in Peripheral Musculoskeletal Structures From Dynamic Volumetric Computed Tomography Using an En Bloc Approach. J Comput Assist Tomogr 2010; 34:626-32. [DOI: 10.1097/rct.0b013e3181d53258] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Jiang HJ, Lu HB, Zhang ZR, Wang YM, Huang Q, Huang YH, Li JP, Shu SJ, Wang JE. Experimental Study on Angiogenesis in a Rabbit VX2 Early Liver Tumour by Perfusion Computed Tomography. J Int Med Res 2010; 38:929-39. [PMID: 20819429 DOI: 10.1177/147323001003800319] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Ten rabbits implanted with VX2 liver tumours were investigated by perfusion computed tomography (PCT) imaging 1 week (early) and 2 weeks (late) after tumour induction; 10 other rabbits were non-implanted controls. Time–density curves, perfusion parametric maps and perfusion parameters were obtained for tumour rim and normal tissue surrounding the tumour, and for liver tissue from the controls. In addition, microvessel density (MVD) and vascular endothelial growth factor (VEGF) were studied by immunohistochemistry 2 weeks after tumour implantation. A deconvolution mathematical model was used to calculate hepatic blood flow (HBF), hepatic blood volume (HBV), mean transit time (MTT), capillary vessel surface permeability (PS) and hepatic arterial index (HAI). At the tumour rim on the early PCT scan, MTT was significantly lower whereas HBF, HBV, HAI and PS were significantly higher than in surrounding normal tissue. There were no significant changes in perfusion parameters on the late PCT scan compared with the early scan. Significant linear correlations of MVD and VEGF were found with HBF, PS and HAI, but not with HBV or MTT. It is concluded that PCT imaging is useful for the evaluation of tumour angiogenesis and for the early detection of liver tumours.
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Affiliation(s)
- HJ Jiang
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - HB Lu
- Department of Oncology, Affiliated Tumour Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - ZR Zhang
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - YM Wang
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - Q Huang
- Department of Pathology, Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - YH Huang
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - JP Li
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - SJ Shu
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
| | - JE Wang
- CT Imaging Centre, Second Affiliated Hospital of Harbin Medical University, Harbin City, Heilongjiang Province, China
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