Zhi Guo Zhuang, Presenter: Nothing to Disclose

Hui Ye, Abstract Co-Author: Research collaboration, Siemens AG

Janina Beilner, Abstract Co-Author: Research collaboration, Siemens AG

Xuebin Zhang, Abstract Co-Author: Nothing to Disclose

Jiachang Chi, Abstract Co-Author: Nothing to Disclose

Jiejun Cheng BMedSc, Abstract Co-Author: Nothing to Disclose

Ji Wang, Abstract Co-Author: Nothing to Disclose

Jianrong Xu, Abstract Co-Author: Nothing to Disclose

To test the hypothesis that in patients with hepatocellular carcinoma (HCC), the blood volume (BV) of tumor and the surrounding liver parenchyma could be measured by Flat Detector computed tomography perfusion (FD-CTP) and the measurements would correlate with those made by the multi-slice CT perfusion (CTP).

15 cirrhotic patients with HCC were investigated with CTP and FD-CTP before transarterial chemoembolization (TACE) procedures. CTP was carried out with intravenous injection protocol on CT (Somatom Definition AS+, Siemens, Germany) and data was postprocessed with commercial software (syngo VPCT Body, Siemens Healthcare, Germany). FD-CTP was performed on C-arm angiographic system (Artis zeego VC13, Siemens, Germany) with intra-arterial injection protocol and the data was postprocessed by prototype software (Siemens Healthcare, Germany). For each patient, BV values of CTP (CTP-BV) and FD-CTP (FD-BV) were measured in detected tumors as well as 3 regions of interest (ROIs) of the liver parenchyma correspondingly. Since the FD-BV only represented the pure arterial BV, the arterial perfusion portion of CTP-BV (CTP-BVarterial) was extracted from the CTP-BV under the assumption that CTP-BVarterial = CTP-BV × HPI, HPI represents the hepatic perfusion index. The BV maps of the two modalities were assessed by two senior radiologists visually. Correlations of the BV values of the two different imaging techniques were calculated.

The image impression of BV maps of the two techniques was judged to appear similar. In all 15 patients, 25 HCC lesions and 45 liver parenchyma ROIs were selected in CTP and FD-CTP maps correspondingly. There were good correlations between the values of FD-BV and CTP-BVarterial (r = 0.831, p < 0.001 for tumor; and r = 0.863, p < 0.001 for liver parenchyma). However, FD-BV was higher than CTP-BVarterial in tumor and liver parenchyma (p <0.001).

FD-CTP for liver seems to be feasible in clinical use. The FD-BV showed good correlation with CTP-BVarterial in both HCC and surrounding liver parenchyma.

FD-CTP offers the ability to quantitatively monitor the hepatic BV changes in the angiographic suite with the patient on-table. It could help to optimize management of HCC during TACE in the future.

Zhuang, Z, Ye, H, Beilner, J, Zhang, X, Chi, J, Cheng, J, Wang, J, Xu, J, Hepatic Blood Volume Imaging Using Flat Detector CT in Comparison to Conventional Multislice CT Perfusion: A Pilot Study in Patients with Hepatocellular Carcinoma.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12026725.html