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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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Garbino N, Brancato V, Salvatore M, Cavaliere C. A Systematic Review on the Role of the Perfusion Computed Tomography in Abdominal Cancer. Dose Response 2021; 19:15593258211056199. [PMID: 34880716 PMCID: PMC8647276 DOI: 10.1177/15593258211056199] [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: 08/02/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background and purpose Perfusion Computed Tomography (CTp) is an imaging technique which allows
quantitative and qualitative evaluation of tissue perfusion through dynamic
CT acquisitions. Since CTp is still considered a research tool in the field
of abdominal imaging, the aim of this work is to provide a systematic
summary of the current literature on CTp in the abdominal region to clarify
the role of this technique for abdominal cancer applications. Materials and Methods A systematic literature search of PubMed, Web of Science, and Scopus was
performed to identify original articles involving the use of CTp for
clinical applications in abdominal cancer since 2011. Studies were included
if they reported original data on CTp and investigated the clinical
applications of CTp in abdominal cancer. Results Fifty-seven studies were finally included in the study. Most of the included
articles (33/57) dealt with CTp at the level of the liver, while a low
number of studies investigated CTp for oncologic diseases involving UGI
tract (8/57), pancreas (8/57), kidneys (3/57), and colon–rectum (5/57). Conclusions Our study revealed that CTp could be a valuable functional imaging tool in
the field of abdominal oncology, particularly as a biomarker for monitoring
the response to anti-tumoral treatment.
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Charalambous S, Perisinakis K, Kontopodis N, Papadakis AE, Galanakis N, Kehagias E, Matthaiou N, Maris TG, Ioannou CV, Tsetis D. Discrimination of High-Risk Type-2 Endoleak after Endovascular Aneurysm Repair through CT Perfusion: A Feasibility Study. J Vasc Interv Radiol 2021; 32:807-812. [PMID: 33771713 DOI: 10.1016/j.jvir.2021.03.525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 12/13/2022] Open
Abstract
A type-2 endoleak after an endovascular aneurysm repair is the most prevalent type of endoleak, but as the clinical consequence of its diagnosis is uncertain, at present, management decisions are solely based on aneurysm sac growth. The aim of this study was to investigate the potential of various computed tomography perfusion parameters for their ability to distinguish high-risk type-2 endoleaks from low-risk type-2 endoleaks after an endovascular aneurysm repair.
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Affiliation(s)
- Stavros Charalambous
- Interventional Radiology Unit and Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Kostas Perisinakis
- Department of Medical Physics, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Nikolaos Kontopodis
- Vascular Surgery Unit and Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Antonios E Papadakis
- Department of Medical Physics, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Nikolaos Galanakis
- Interventional Radiology Unit and Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Elias Kehagias
- Interventional Radiology Unit and Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Nikolas Matthaiou
- Interventional Radiology Unit and Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Thomas G Maris
- Department of Medical Physics, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Christos V Ioannou
- Vascular Surgery Unit and Department of Cardiothoracic and Vascular Surgery, University Hospital of Heraklion, University of Crete Medical School, Greece
| | - Dimitrios Tsetis
- Interventional Radiology Unit and Department of Medical Imaging, University Hospital of Heraklion, University of Crete Medical School, Greece.
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Pancreatic perfusion imaging method that reduces radiation dose and maintains image quality by combining volumetric perfusion CT with multiphasic contrast enhanced-CT. Pancreatology 2020; 20:1406-1412. [PMID: 32888809 DOI: 10.1016/j.pan.2020.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/09/2020] [Accepted: 08/20/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aim of this study is to propose and evaluate a new method of volumetric perfusion computed tomography (PCT) incorporated into pancreatic multiphasic contrast enhanced (CE)-CT in the clinical setting. METHODS In this ethically approved study, PCT was incorporated into our existing scanning protocol in 17 patients and effective doses related to PCT were evaluated. CT values and signal-to-noise ratio (SNR) of anatomical structure were compared in diagnostic images that were acquired using 320-detector volumetric scan mode and 64-detector helical scan mode. In addition, focal lesion depiction was qualitatively assessed in the two groups. Perfusion parameters in normal pancreas were measured by two radiologists and the interobserver-reliability was assessed. RESULTS The effective dose of PCT was 5.1 ± 0.3 mSv. The actual effective dose (AED) including the dose used in volumetric scans for diagnostic imaging was 22.8 ± 5.3 mSv and the putative effective dose (PED) was 21.9 ± 9.1 mSv on average. There was no significant difference between AED and PED (p = 0.404). Compared with conventional helical scans, volumetric scans did not decrease CT values or SNR, but rather significantly increased those of the aorta in the arterial phase. Both groups had acceptable qualitatively assessed image quality with no significant difference in the depiction of each structure. There was almost perfect interobserver agreement in the measurement of perfusion parameters (mean ICCs > 0.9). CONCLUSIONS Our scanning protocol for pancreatic perfusion CT provides high-quality images while requiring lower radiation doses than conventional methods.
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Dynamic CT perfusion imaging for type 2 endoleak assessment after endograft placement. Med Hypotheses 2020; 139:109701. [DOI: 10.1016/j.mehy.2020.109701] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 03/21/2020] [Accepted: 03/30/2020] [Indexed: 12/12/2022]
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Kantarci M, Pirimoglu B. Radiological Response to the Locoregional Treatment in Hepatocellular Carcinoma: RECIST, mRECIST, and Others. J Gastrointest Cancer 2017. [PMID: 28624974 DOI: 10.1007/s12029-017-9969-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Mecit Kantarci
- Department of Radiology, Faculty of Medicine, Ataturk University, 25040, Erzurum, Turkey.
| | - Berhan Pirimoglu
- Department of Radiology, Faculty of Medicine, Ataturk University, 25040, Erzurum, Turkey
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Topcuoğlu OM, Karçaaltıncaba M, Akata D, Özmen MN. Reproducibility and variability of very low dose hepatic perfusion CT in metastatic liver disease. Diagn Interv Radiol 2017; 22:495-500. [PMID: 27759566 DOI: 10.5152/dir.2016.16612] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE We aimed to determine the intra- and interobserver agreement on the software analysis of very low dose hepatic perfusion CT (pCT). METHODS A total of 53 pCT examinations were obtained from 21 patients (16 men, 5 women; mean age, 60.4 years) with proven liver metastasis from various primary cancers. The pCT examinations were analyzed by two readers independently and perfusion parameters were noted for whole liver, whole metastasis, metastasis wall, and normal-looking liver (liver tissue without metastasis) in regions of interest (ROIs). Readers repeated the analysis after an interval of one month. Intra- and interobserver agreements were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics. RESULTS The mean ICCs of all ROIs between readers were 0.91, 0.93, 0.86, 0.45, 0.53, and 0.66 for blood flow (BF), blood volume (BV), permeability, arterial liver perfusion (ALP), portal venous perfusion (PVP) and hepatic perfusion index (HPI), respectively. The mean ICCs of all ROIs between readings were 0.86, 0.91, 0.81, 0.53, 0.56, and 0.71 for BF, BV, permeability, ALP, PVP, and HPI, respectively. There was greater agreement on the parameters measured for the whole metastasis than on the parameters measured for the metastasis wall. The effective dose of all perfusion CT studies was 2.9 mSv. CONCLUSION There is greater intra- and interobserver agreement for BF and BV than for permeability, ALP, PVP, and HPI at very low dose hepatic pCT. Permeability, ALP, PVP, and HPI parameters cannot be used in clinical practice for hepatic pCT with an effective dose of 2.9 mSv.
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Pirimoglu B, Sade R, Ogul H, Kantarci M, Eren S, Levent A. How Can New Imaging Modalities Help in the Practice of Radiology? Eurasian J Med 2017; 48:213-221. [PMID: 28149149 DOI: 10.5152/eajm.2016.0260] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this article was to provide an up-to-date review on the spectrum of new imaging applications in the practice of radiology. New imaging techniques have been developed with the objective of obtaining structural and functional analyses of different body systems. Recently, new imaging modalities have aroused the interest of many researchers who are studying the applicability of these modalities in the evaluation of different organs and diseases. In this review article, we present the efficiency and utilization of current imaging modalities in daily radiological practice.
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Affiliation(s)
- Berhan Pirimoglu
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Recep Sade
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hayri Ogul
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Mecit Kantarci
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Suat Eren
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Akın Levent
- Department of Radiology, Ataturk University School of Medicine, Erzurum, Turkey
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Uncommon Complex Anomaly of Inferior Vena Cava and Left Iliac Vein Demonstrated by Multidetector-Row CT Angiography. Int Surg 2016; 99:863-7. [PMID: 25437601 DOI: 10.9738/intsurg-d-13-00132.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Retroperitoneal venous anomalies have clinical importance in retroperitoneal and pelvic surgery. Multidetector-row computed tomography (CT) angiography is an important imaging method to be preferred in evaluating vascular structures in this locality. We describe a complex retroperitoneal venous anomaly with a multidetector-row CT angiography.
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Oğul H, Kantarcı M, Genç B, Pirimoğlu B, Cullu N, Kızrak Y, Yılmaz O, Karabulut N. Perfusion CT imaging of the liver: review of clinical applications. Diagn Interv Radiol 2015; 20:379-89. [PMID: 24834487 DOI: 10.5152/dir.2014.13396] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Perfusion computed tomography (CT) has a great potential for determining hepatic and portal blood flow; it offers the advantages of quantitative determination of lesion hemodynamics, distinguishing malignant and benign processes, as well as providing morphological data. Many studies have reported the use of this method in the assessment of hepatic tumors, hepatic fibrosis associated with chronic liver disease, treatment response following radiotherapy and chemotherapy, and hepatic perfusion changes after radiological or surgical interventions. The main goal of liver perfusion imaging is to improve the accuracy in the characterization of liver disorders. In this study, we reviewed the clinical application of perfusion CT in various hepatic diseases.
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Affiliation(s)
- Hayri Oğul
- Department of Radiology, Atatürk University, School of Medicine, Erzurum, Turkey.
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Kantarci M, Pirimoglu B, Ozturk G, Aydinli B, Ogul H, Okur A, Kizrak Y, Ozyigit O, Celik M. Clinical utility of hepatic-perfusion computerized tomography in living-donor liver transplantation: a preliminary study. Transplant Proc 2015; 47:399-407. [PMID: 25769581 DOI: 10.1016/j.transproceed.2014.11.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 11/10/2014] [Accepted: 11/25/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Vascular complications are a primary diagnostic consideration in liver transplant recipients, with an overall incidence of 9%. Cross-sectional imaging techniques provide information regarding vascular structure and luminal patency but can not quantitatively assess hepatocyte damage in the liver graft parenchyma. Perfusion computerized tomography (CT) is a recently developed method that allows for quantitative evaluation of hemodynamic changes in tissue. Our objective was to evaluate the clinical utility of perfusion CT in assessing vascular complications during living-donor liver transplantation (LDLT). METHODS The 33 recipients were divided into 3 groups according to Doppler ultrasonographic findings: hepatic arterial complication group, portal venous complication group, and hepatic venous complication group. Blood volume (BV), blood flow (BF), arterial liver perfusion (ALP), portal venous perfusion (PVP), and hepatic perfusion index (HPI) were calculated for the affected vascular territory regions. RESULTS Compared with normal liver parenchyma, BV, BF, ALP, and HPI were significantly lower in the hepatic arterial complication group. Although PVP and BV were significantly lower, ALP, HPI, and BF were higher in the affected vascular territory region than in normal liver parenchyma for the portal venous complication group. In the hepatic venous complication group, PVP was significantly higher and BF, ALP, and HPI significantly lower in the affected vascular territory regions than in normal liver parenchyma. CONCLUSIONS Perfusion CT imaging is a noninvasive technique that enables the quantitative evaluation of vascular complications in the graft parenchyma after LDLT and permits a quantitative evaluation of the treatment response.
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Affiliation(s)
- M Kantarci
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey.
| | - B Pirimoglu
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - G Ozturk
- Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey
| | - B Aydinli
- Department of General Surgery, School of Medicine, Atatürk University, Erzurum, Turkey
| | - H Ogul
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - A Okur
- Department of Radiology, Yozgat, School of Medicine, Bozok University, Bozok, Turkey
| | - Y Kizrak
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - O Ozyigit
- Department of Radiology, School of Medicine, Atatürk University, Erzurum, Turkey
| | - M Celik
- Department of Anesthesiology and Reanimation, School of Medicine, Atatürk University, Erzurum, Turkey
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Pneumatosis cystoides intestinalis: an unusual cause of intestinal ischemia and pneumoperitoneum. Int Surg 2015; 100:221-4. [PMID: 25692421 DOI: 10.9738/intsurg-d-13-00238.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Pneumatosis cystoides intestinalis (PCI), with an unknown etiology, is an uncommon disease characterized by the presence of multiple gas-filled cysts within the submucosa or subserosa of the intestinal wall. Intestinal obstruction and/or perforation are relatively uncommon complications associated with PCI. The patients are often prone to misdiagnosis or mistreatment. The diagnosis of PCI is based on plain radiography or endoscopy. Multidetector computed tomography (MDCT) provides data on other intra-abdominal pathologies. Therefore, it is an important modality for the diagnosis of PCI. We present a case of PCI in a 58-year-old man affected by peritoneal free air with multidetector computed tomography imaging findings. We performed the plain film of the abdomen, and MDCT studies that showed numerous, diffuse, bubble-like intramural gas collections into the jejunum, ileum, and colon walls at the left-upper quadrant of the abdomen. MDCT findings were confirmed by surgical exploration.
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The pelvic digit anomaly in a patient with multiple fractures: does it mimic the fracture? Am J Emerg Med 2013; 31:1537.e1-2. [DOI: 10.1016/j.ajem.2013.05.033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Revised: 05/16/2013] [Accepted: 05/21/2013] [Indexed: 11/22/2022] Open
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