Sébastien Mulé1, Frédéric Pigneur2, Ronan Quelever3, Arthur Tenenhaus4,5, Laurence Baranes2, Philippe Richard3, Vania Tacher2,6,7, Edouard Herin2, Hugo Pasquier2,6, Maxime Ronot8,9,10, Alain Rahmouni2,6, Valérie Vilgrain8,9,10, Alain Luciani2,6,7. 1. Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, 94010, Creteil Cedex, France. sebastien.mule@gmail.com. 2. Service d'Imagerie Médicale, AP-HP, Hôpitaux Universitaires Henri Mondor, 51 Avenue du Marechal de Lattre de Tassigny, 94010, Creteil Cedex, France. 3. GE Healthcare, 283 rue de la Minière, 78530, Buc, France. 4. Laboratoire des Signaux et Systèmes, Université Paris-Saclay, Orsay, France. 5. Biostatistics and bioinformatics core facility, Brain and Spine Institute, Paris, France. 6. Faculté de Médecine, Université Paris Est Creteil, Creteil, France. 7. , INSERM IMRB, U 955, Equipe 18, Creteil, France. 8. Service de Radiologie, AP-HP, Hôpitaux Universitaires Paris Nord Val de Seine, Beaujon, 100 boulevard General Leclerc, 92118, Clichy, France. 9. Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 10. INSERM U1149, centre de recherche biomédicale Bichat-Beaujon, CRB3, Paris, France.
Abstract
OBJECTIVES: To determine the degree of relationship between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT parameters in patients with advanced HCC under treatment. METHODS: In this single-centre IRB approved study, 16 patients with advanced HCC treated with sorafenib or radioembolization who underwent concurrent dynamic perfusion CT and multiphase DECT using a single source, fast kV switching DECT scanner were included. Written informed consent was obtained for all patients. HCC late-arterial and portal iodine concentrations, blood flow (BF)-related and blood volume (BV)-related perfusion parameters maps were calculated. Mixed-effects models of the relationship between iodine concentrations and perfusion parameters were computed. An adjusted p value (Bonferroni method) < 0.05 was considered significant. RESULTS: Mean HCC late-arterial and portal iodine concentrations were 22.7±12.7 mg/mL and 18.7±8.3 mg/mL, respectively. Late-arterial iodine concentration was significantly related to BV (mixed-effects model F statistic (F)=28.52, p<0.0001), arterial BF (aBF, F=17.62, p<0.0001), hepatic perfusion index (F=28.24, p<0.0001), positive enhancement integral (PEI, F=66.75, p<0.0001) and mean slope of increase (F=32.96, p<0.0001), while portal-venous iodine concentration was mainly related to BV (F=29.68, p<0.0001) and PEI (F=66.75, p<0.0001). CONCLUSIONS: In advanced HCC lesions, DECT-derived late-arterial iodine concentration is strongly related to both aBF and BV, while portal iodine concentration mainly reflects BV, offering DECT the ability to evaluate both morphological and perfusion changes. KEY POINTS: • Late-arterial iodine concentration is highly related to arterial BF and BV. • Portal iodine concentration mainly reflects tumour blood volume. • Dual-energy CT offers significantly decreased radiation dose compared with perfusion CT.
OBJECTIVES: To determine the degree of relationship between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT parameters in patients with advanced HCC under treatment. METHODS: In this single-centre IRB approved study, 16 patients with advanced HCC treated with sorafenib or radioembolization who underwent concurrent dynamic perfusion CT and multiphase DECT using a single source, fast kV switching DECT scanner were included. Written informed consent was obtained for all patients. HCC late-arterial and portal iodine concentrations, blood flow (BF)-related and blood volume (BV)-related perfusion parameters maps were calculated. Mixed-effects models of the relationship between iodine concentrations and perfusion parameters were computed. An adjusted p value (Bonferroni method) < 0.05 was considered significant. RESULTS: Mean HCC late-arterial and portal iodine concentrations were 22.7±12.7 mg/mL and 18.7±8.3 mg/mL, respectively. Late-arterial iodine concentration was significantly related to BV (mixed-effects model F statistic (F)=28.52, p<0.0001), arterial BF (aBF, F=17.62, p<0.0001), hepatic perfusion index (F=28.24, p<0.0001), positive enhancement integral (PEI, F=66.75, p<0.0001) and mean slope of increase (F=32.96, p<0.0001), while portal-venous iodine concentration was mainly related to BV (F=29.68, p<0.0001) and PEI (F=66.75, p<0.0001). CONCLUSIONS: In advanced HCC lesions, DECT-derived late-arterial iodine concentration is strongly related to both aBF and BV, while portal iodine concentration mainly reflects BV, offering DECT the ability to evaluate both morphological and perfusion changes. KEY POINTS: • Late-arterial iodine concentration is highly related to arterial BF and BV. • Portal iodine concentration mainly reflects tumour blood volume. • Dual-energy CT offers significantly decreased radiation dose compared with perfusion CT.
Authors: Wolfgang M Thaiss; Ulrike Haberland; Sascha Kaufmann; Daniel Spira; Christoph Thomas; Konstantin Nikolaou; Marius Horger; Alexander W Sauter Journal: Eur Radiol Date: 2015-12-17 Impact factor: 5.315
Authors: Tianying Zheng; Hanyu Jiang; Yi Wei; Zixing Huang; Jie Chen; Ting Duan; Bin Song Journal: Chin J Cancer Res Date: 2018-06 Impact factor: 5.087