Abstract

Background

Computed tomography perfusion imaging (CTPI) by repeated scanning has clinical relevance but implies relatively high radiation exposure. We present a method to measure perfusion from two CT scan phases only, considering tissue enhancement, feeding vessel (aortic) peak enhancement, and bolus shape.

Methods

CTPI scans (each with 40 frames acquired every 1.5 s) of 11 patients with advanced hepatocellular carcinoma (HCC) enrolled between 2012 and 2016 were retrospectively analysed (aged 69 ± 9 years, 8/11 males). Perfusion was defined as the maximal slope of the time-enhancement curve divided by the peak enhancement of the feeding vessel (aorta). Perfusion was computed two times, first using the maximum slope derived from all data points and then using the peak tissue enhancement and the bolus shape obtained from the aortic curve.

Results

Perfusion values from the two methods were linearly related (r2 = 0.92, p < 0.001; Bland–Altman analysis bias -0.12). The mathematical model showed that the perfusion ratio of two ROIs with the same feeding vessel (aorta) corresponds to their peak enhancement ratio (r2 = 0.55, p < 0.001; Bland–Altman analysis bias -0.68). The relationship between perfusion and tissue enhancement is predicted to be linear in the clinical range of interest, being only function of perfusion, peak feeding vessel enhancement, and bolus shape.

Conclusions

This proof-of-concept study showed that perfusion values of HCC, kidney, and pancreas could be computed using enhancement measured only with two CT scan phases, if aortic peak enhancement and bolus shape are known.

Details

Title
Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
Author
Cressoni, Massimo 1 ; Cozzi, Andrea 1   VIAFID ORCID Logo  ; Schiaffino, Simone 1 ; Cadringher, Paolo 2 ; Vitali, Paolo 3 ; Basso, Gianpaolo 4 ; Ippolito, Davide 5 ; Sardanelli, Francesco 3 

1  IRCCS Policlinico San Donato, Unit of Radiology, San Donato Milanese, Italy (GRID:grid.419557.b) (ISNI:0000 0004 1766 7370) 
2  Elekton S.A.S., Regione Crena 15A, Agliano Terme, Italy (GRID:grid.419557.b) 
3  IRCCS Policlinico San Donato, Unit of Radiology, San Donato Milanese, Italy (GRID:grid.419557.b) (ISNI:0000 0004 1766 7370); Università degli Studi di Milano, Department of Biomedical Sciences for Health, Milan, Italy (GRID:grid.4708.b) (ISNI:0000 0004 1757 2822) 
4  Università degli Studi di Milano-Bicocca, School of Medicine and Surgery, Milan, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754) 
5  Università degli Studi di Milano-Bicocca, School of Medicine and Surgery, Milan, Italy (GRID:grid.7563.7) (ISNI:0000 0001 2174 1754); ASST Monza—Ospedale San Gerardo, Department of Radiology, Monza, Italy (GRID:grid.415025.7) (ISNI:0000 0004 1756 8604) 
Publication year
2022
Publication date
Dec 2022
Publisher
Springer Nature B.V.
e-ISSN
25099280
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1186/s41747-022-00292-y
ProQuest document ID
2707469192
Copyright
© The Author(s) under exclusive licence to European Society of Radiology 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.