Sascha Kaufmann, Abstract Co-Author: Nothing to Disclose

Maximilian Michael Walther Schulze MD, Abstract Co-Author: Nothing to Disclose

Daniel Spira MD, Abstract Co-Author: Nothing to Disclose

Alexander Sauter, Abstract Co-Author: Nothing to Disclose

Claus Detlef Claussen MD, Abstract Co-Author: Nothing to Disclose

Marius Horger MD, Presenter: Nothing to Disclose

Konstantin Nikolaou MD, Abstract Co-Author: Speakers Bureau, Siemens AG Speakers Bureau, Bracco Group Speakers Bureau, Bayer AG

To assess average perfusion values for blood flow (BF), blood volume (BV), k-trans, in hepatocellular carcinoma (HCC) measured with two different mathematical models as well as to determine the degree of arterial liver perfusion (ALP), portal venous perfusion (PVP-if any) and hepatic arterial index (HPI), the latter three being calculated by a special software which separates the contribution of the dual vascular (arterial/portal-venous) supply of the liver.

Institutional review board approval was obtained for this prospective study. VPCT was performed in 81 patients covering the involved liver (80kV, 100/120mAs) using 64x0.6mm collimation, 26 consecutive volume measurements, IV injection of 50 mL of iodinated contrast at a flow rate of 5 mL/s). BF, BV and k-trans were measured using: maximum slope + Patlak analysis vs. deconvolution method.

For maximum slope + Patlak analysis BF/BV/k-trans yielded following avg. values values: 37.6/9.8/36.5 (SD: 14.7/7.1/16.5). For the deconvolution method mean BF/BV/k-trans were 67.7/12.5/24.2 (SD: 25.3/6.3/7.3), respectively. Separate calculation of ALP, PVP and HPI resulted in following values: 53.8/2.4/96.5 (SD: 15.0/5.4/7.2).  

The deconvolution method results in more robust calculation of BV and k-trans whereas the max. slope + Patlak method yields higher variations of all calculated perfusion parameters. Moreover, the deconvolution method results in significantly higher BF, slightly higher BV and lower k-trans, but the relationship between results of both calculation models is congruent. The HPI was expectedly very high in all tumors.

Perfusion imaging is an emerging technology which is beneficial both for tumor detection and characterisation as well as for therapy response monitoring. International guidelines for diagnosis of HCC allow for non-invasive diagnosis based on the presence of positive wash-in and wash-out tumor characteristics. However, not all HCC behave this way and perfusion quantification, particularly the HPI value may help for more accurate diagnosis and monitoring. Therefore orientation values are mandatory.

Kaufmann, S, Schulze, M, Spira, D, Sauter, A, Claussen, C, Horger, M, Nikolaou, K, Characterization of Perfusion Parameters in Hepatocellular Carcinoma (HCC) with Aid of Volume Perfusion CT (VPCT): Correlation between Two Different Mathematical Models.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14016703.html