Jeong Hee Yoon MD, Presenter: Nothing to Disclose

Jeong Min Lee MD, Abstract Co-Author: Research Grant, Guerbet SA Equipment support, Siemens AG Research Grant, Bayer AG

Hackjoon Shim, Abstract Co-Author: Employee, Toshiba Corporation

Joon Koo Han MD, Abstract Co-Author: Nothing to Disclose

Byung Ihn Choi MD, PhD, Abstract Co-Author: Research Consultant, Samsung Electronics Co Ltd

To establish the protocol of perfusion computed tomography (CT) using a 320-dectector CT for pancreas tumor evaluation.

This prospective study was approved by our institutional review board and informed consent was obtained from all patients. A total of 27 patients (M:F=22:5, mean age 52 years) with pancreas tumors were enrolled. Among them, 18 patients underwent pancreas resection (group 1: pancreas adenocarcinoma [PAC], n=14; neuroendocrine tumor [NET], n=3; and undifferentiated carcinoma n=1) and the remaining 9 patients received chemotherapy for PAC (group 2, Gemcitabine-based [n=4], and FOLFIRINOX [n=5]). All patients underwent perfusion CT before treatment, and group 2 underwent follow-up perfusion CT after finishing 2nd cycles of chemotherapy. Perfusion CT scan was performed with 100kVp, volumetric scan, and followed by routine abdominopelvic CT for extrapancreatic imaging. The perfusion parameters obtained by maximal slope (arterial flow, [AF]) and Patlak models (Flow, blood volume [BV]) were compared between tumors and pre- and post- chemotherapy CT. Parameters were also compared between non-responder (PD, SD) and responder (PR, CR) based on RECIST 1.1 criteria.

PAC showed significantly lower AF, BV than normal parenchyma (P<0.001), and NET (P<0.001). However, there was no significant differences of flow among PAC, NET and normal pancreas (P>0.05). Between responder (n=3) and non-responder (n=6), there were no significant differences of initial perfusion CT parameters between two groups (P>0.05). However, responders showed early rise of BV, compared to non-responders (△BV: 142.0±30.9, 23.2±56.9%, respectively). In nine patients who received chemotherapy, there was no significant difference of perfusion parameters between different chemotherapy regimen groups.  

Perfusion CT might provide additional information for pancreas tumor characterization and response evaluation. In addition, combining abdominopelvic CT with perfusion CT provided all-in-one protocol for patients with pancreas tumor. 

Perfusion CT may serve additional role for pancreas tumor imaging, and may predict pathophysiologic changes of tumors non-invasively. 

Yoon, J, Lee, J, Shim, H, Han, J, Choi, B, Perfusion Computed Tomography for Pancreas Cancer Imaging Using a 320 Channel Wide Detector .  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14045792.html