Faculty Collaboration Database

Effect of dual vascular input functions on CT perfusion parameter values and reproducibility in liver tumors and normal liver. J Comput Assist Tomogr 2012;36(4):388-93

Date

07/19/2012

Pubmed ID

22805665

Pubmed Central ID

PMC3891838

DOI

10.1097/RCT.0b013e318256b1e2

Scopus ID

2-s2.0-84863892216 (requires institutional sign-in at Scopus site)   13 Citations

Abstract

OBJECTIVE: To assess the impact on absolute values and reproducibility of adding portal venous (PV) to arterial input functions in computed tomographic perfusion (CTp) evaluations of liver tumors and normal liver.

METHODS: Institutional review board approval and written informed consent were obtained; the study complied with Health Insurance Portability and Accountability Act regulations. Computed tomographic perfusion source data sets, obtained from 7 patients (containing 9 liver tumors) on 2 occasions, 2 to 7 days apart, were analyzed by deconvolution modeling using dual ("Liver" protocol: PV and aorta) and single ("Body" protocol: aorta only) vascular inputs. Identical tumor, normal liver, aortic and, where applicable, PV regions of interest were used in corresponding analyses to generate tissue blood flow (BF), blood volume (BV), mean transit time (MTT), and permeability (PS) values. Test-retest variability was assessed by within-patient coefficients of variation.

RESULTS: For liver tumor and normal liver, median BF, BV, and PS were significantly higher for the Liver protocol than for the Body protocol: 171.3 to 177.8 vs 39.4 to 42.0 mL/min per 100 g, 17.2 to 18.7 vs 3.1 to 4.2 mL/100 g, and 65.1 to 78.9 vs 50.4 to 66.1 mL/min per 100 g, respectively (P < 0.01 for all). There were no differences in MTT between protocols. Within-patient coefficients of variation were lower for all parameters with the Liver protocol than with the Body protocol: BF, 7.5% to 11.2% vs 11.7% to 20.8%; BV, 10.1% to 14.4% vs 16.6% to 30.1%; MTT, 4.2% to 5.5% vs 10.4% to 12.9%; and PS, 7.3% to 12.1% vs 12.6% to 20.3%, respectively.

CONCLUSION: Utilization of dual vascular input CTp liver analyses has substantial impact on absolute CTp parameter values and test-retest variability. Incorporation of the PV inputs may yield more precise results; however, it imposes substantial practical constraints on acquiring the necessary data.

Author List

Ng CS, Chandler AG, Wei W, Anderson EF, Herron DH, Kurzrock R, Charnsangavej C

Author

Razelle Kurzrock MD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Blood Flow Velocity
Blood Volume
Contrast Media
Female
Humans
Liver
Liver Neoplasms
Male
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Tomography, X-Ray Computed
Triiodobenzoic Acids