Mika Kitajima MD, Presenter: Nothing to Disclose

Toshinori Hirai MD, Abstract Co-Author: Nothing to Disclose

Yasuhiko Iryo, Abstract Co-Author: Nothing to Disclose

Hideo Nakamura MD, Abstract Co-Author: Nothing to Disclose

Eri Hayashida, Abstract Co-Author: Nothing to Disclose

Minako Azuma, Abstract Co-Author: Nothing to Disclose

Seitaro Oda MD, Abstract Co-Author: Nothing to Disclose

Daisuke Utsunomiya MD, Abstract Co-Author: Nothing to Disclose

Yasuyuki Yamashita MD, Abstract Co-Author: Consultant, DAIICHI SANKYO Group

We assessed whether 320-section low-dose dynamic volume CT (LDVCT) with adaptive iterative dose reduction (AIDR) adds value to standard 3T MRI for the preoperative evaluation of brain tumors.

In addition to preoperative 3T MRI, 15 patients (5 men, 10 women; age 28-78 years, mean 58 years) with brain tumors underwent a 320-section LDVCT scan with AIDR acquired at a tube voltage of 80 kV and a tube current-time product of 100 mAs. The tumors were glioblastoma (n=5), meningioma (n=4), oligodendroglioma (n=3), and hemangiopericytoma or ependymoma (n=1 each). The images reconstructed from LDVCT data included pre- and post-contrast CT, 3D CT angiography (CTA), 4D CTA, 3D CT venography (CTV), and perfusion CT. The MRI sequences included T1-, T2-, and diffusion-weighted, and FLAIR, and postcontrast T1-weighted images, MR angiography (MRA), and perfusion imaging. Two radiologists independently evaluated the CT and MRI studies; one measured the relative cerebral blood volume (rCBV) in the tumor and contralateral brain on CT and MR perfusion maps. Interobserver agreement was assessed by κ statistics. The referring neurosurgeons reported whether 320-section LDVCT added useful information to the 3T MR images for surgical planning.

LDVCT was superior to 3T MRI in 3 of 15 tumors for the visualization of arterial feeders (κ = 0.77), in 12 for the delineation of venous structures (κ = 0.71), and in 6 for understanding the relationship of the tumor to adjacent arteries and venous structures (κ = 0.82). MR perfusion in one case could not be assessed because of tumor hemorrhage, while CT perfusion could be done. The average standardized rCBV value was 12.5 ± 2.30 on MR perfusion- and 8.7 ± 2.68 on CT perfusion maps; the correlation between these images was good (r ꞊ 0.88, p < 0.001). In 10 of 15 operated patients, especially those with hypervascular tumors, the additional information obtained with LDVCT was useful for surgical planning.

For the preoperative evaluation of brain tumors, 320-section LDVCT images add useful information to standard 3T MRI.

320-section LDVCT images are a useful supplement to standard 3T MRI for the preoperative evaluation of brain tumors.

Kitajima, M, Hirai, T, Iryo, Y, Nakamura, H, Hayashida, E, Azuma, M, Oda, S, Utsunomiya, D, Yamashita, Y, Does 320-section Low-dose Dynamic Volume CT Add Information to 3T MRI for the Preoperative Evaluation of Brain Tumors?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045661.html