Wolfgang M Thaiss1, Ulrike Haberland2, Sascha Kaufmann1, Daniel Spira1,3, Christoph Thomas1,4, Konstantin Nikolaou1, Marius Horger1, Alexander W Sauter5,6. 1. Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str. 3, D-72076, Tübingen, Germany. 2. Siemens AG, Healthcare Sector, Computed Tomography, H IM CR R&D PA SC, Siemensstr. 1, D-91301, Forchheim, Germany. 3. Diagnostic and Interventional Radiology, University Medical Center Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Germany. 4. Institute for Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Moorenstr. 5, D-40225, Düsseldorf, Germany. 5. Department of Radiology, Diagnostic and Interventional Radiology, Eberhard Karls University, Hoppe-Seyler-Str. 3, D-72076, Tübingen, Germany. alexander.sauter@usb.ch. 6. Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland. alexander.sauter@usb.ch.
Abstract
OBJECTIVES: To assess the value of iodine concentration (IC) in computed tomography data acquired with 80 kVp, as a surrogate for perfusion imaging in hepatocellular carcinoma (HCC) and lymphoma by comparing iodine related attenuation (IRA) with quantitative Volume Perfusion CT (VPCT)-parameters. METHODS: VPCT-parameters were compared with intra-tumoral IC at 5 time points after the aortic peak enhancement (APE) with a temporal resolution of 3.5 sec in untreated 30 HCC and 30 lymphoma patients. RESULTS: Intra-tumoral perfusion parameters for HCC showed a blood flow (BF) of 52.7 ± 17.0 mL/100 mL/min, blood volume (BV) 12.6 ± 4.3 mL/100 mL, arterial liver perfusion (ALP) 44.4 ± 12.8 mL/100 mL/min. Lesion IC 7 sec after APE was 133.4 ± 57.3 mg/100 mL. Lymphoma showed a BF of 36.8 ± 13.4 mL/100 mL/min, BV of 8.8 ± 2.8 mL/100 mL and IC of 118.2 ± 64.5 mg/100 mL 3.5 sec after APE. Strongest correlations exist for VPCT-derived BF and ALP with IC in HCC 7 sec after APE (r = 0.71 and r = 0.84) and 3.5 sec after APE in lymphoma lesions (r = 0.77). Significant correlations are also present for BV (r = 0.60 and r = 0.65 for HCC and lymphoma, respectively). CONCLUSIONS: We identified a good, time-dependent agreement between VPCT-derived flow values and IC in HCC and lymphoma. Thus, CT-derived ICs 7 sec after APE in HCC and 3.5 sec in lymphoma may be used as surrogate imaging biomarkers for tumor perfusion with 80 kVp. KEY POINTS: • Iodine concentration derived from low kVp CT is regarded as perfusion surrogate • Correlation with Perfusion CT was performed to elucidate timing and histology dependencies • Highest correlation was present 7 sec after aortic peak enhancement in hepatocellular carcinoma • In lymphoma, highest correlation was calculated 3.5 sec after aortic peak enhancement • With these results, further optimization of Dual energy CT protocols is possible.
OBJECTIVES: To assess the value of iodine concentration (IC) in computed tomography data acquired with 80 kVp, as a surrogate for perfusion imaging in hepatocellular carcinoma (HCC) and lymphoma by comparing iodine related attenuation (IRA) with quantitative Volume Perfusion CT (VPCT)-parameters. METHODS: VPCT-parameters were compared with intra-tumoral IC at 5 time points after the aortic peak enhancement (APE) with a temporal resolution of 3.5 sec in untreated 30 HCC and 30 lymphomapatients. RESULTS: Intra-tumoral perfusion parameters for HCC showed a blood flow (BF) of 52.7 ± 17.0 mL/100 mL/min, blood volume (BV) 12.6 ± 4.3 mL/100 mL, arterial liver perfusion (ALP) 44.4 ± 12.8 mL/100 mL/min. Lesion IC 7 sec after APE was 133.4 ± 57.3 mg/100 mL. Lymphoma showed a BF of 36.8 ± 13.4 mL/100 mL/min, BV of 8.8 ± 2.8 mL/100 mL and IC of 118.2 ± 64.5 mg/100 mL 3.5 sec after APE. Strongest correlations exist for VPCT-derived BF and ALP with IC in HCC 7 sec after APE (r = 0.71 and r = 0.84) and 3.5 sec after APE in lymphoma lesions (r = 0.77). Significant correlations are also present for BV (r = 0.60 and r = 0.65 for HCC and lymphoma, respectively). CONCLUSIONS: We identified a good, time-dependent agreement between VPCT-derived flow values and IC in HCC and lymphoma. Thus, CT-derived ICs 7 sec after APE in HCC and 3.5 sec in lymphoma may be used as surrogate imaging biomarkers for tumor perfusion with 80 kVp. KEY POINTS: • Iodine concentration derived from low kVp CT is regarded as perfusion surrogate • Correlation with Perfusion CT was performed to elucidate timing and histology dependencies • Highest correlation was present 7 sec after aortic peak enhancement in hepatocellular carcinoma • In lymphoma, highest correlation was calculated 3.5 sec after aortic peak enhancement • With these results, further optimization of Dual energy CT protocols is possible.
Authors: Daniel Spira; Patrick Adam; Catharina Linder; Sven Michael Spira; Jan Pintoffl; Claus Detlef Claussen; Marius Horger Journal: AJR Am J Roentgenol Date: 2012-06 Impact factor: 3.959
Authors: Anno Graser; Christoph R Becker; Michael Staehler; Dirk A Clevert; Michael Macari; Niko Arndt; Konstantin Nikolaou; Wieland Sommer; Christian Stief; Maximilian F Reiser; Thorsten R C Johnson Journal: Invest Radiol Date: 2010-07 Impact factor: 6.016