Aims and objectives
Perfusion computed tomography (CTp) is an imaging technique that provides qualitative and quantitative information regarding tumor angiogenesis [1,2].
It can quantify the real perfusion of tissues by applying mathematical models and dedicated software to calculate the delivery of contrast agent,
and therefore blood,
to tissues [3-4].
CT perfusion protocols depend on the scanning technique and mathematic modeling.
Mathematic models are based on compartmental or deconvolution methods [1].
The analytical methods used (slope method,
two- compartment,
deconvolution,
Patlak plotting) differ between vendor specifications [4-6].
In clinical...
Methods and materials
In our study 22 patients aged 44 to 76 years (mean age 61 years) with histologically proven clear cell renal cell carcinoma (ccRCC) were examined between February 2018 and October 2018.
Male to female=2:1.
All of themwere underwent renal CT perfusion imaging before surgical resection and pathological analysis in P.
Hertsen Moscow Oncology Research Institute.
Exclusion criteria were significant respiratory artifacts which couldn’t be reduced with post processing and previous antiangiogenic treatment.
All patients were examined with 80-sliced and 64-sliced СТ scanners.
Patients were required...
Results
According to the study mean perfusion CT parameter values (BV,
Clearance and BF or BF,
BV,
MTT and PS) for normal renal cortex and the renal tumors are summarized in Table 1 for the first group and in Table 2 for the second group.
Significant differences between RCC and normal renal cortex in all investigated parameters were found in both groups (P=0.001) Fig.
4-5.
Deconvolution is more simple method of postprocessing,
it takes about 5 minutes.
Patlak plotting is operator depending and very sensitive to...
Conclusion
The Patlak and the deconvolution methods have its advantages and disadvantages.
The main advantage of the Patlak method is low effective radiation dose,
but this method requires an experienced radiologist who can minimize noise and quickly perform post-processing.
The deconvolution method is easier to use,
but the effective radiation doseis significantly greater than in the first case.
The following conditions may optimize the pCT of RCC: minimization of respiratory artifacts (slight breathing and abdominal belt) and reduction the effective dose by decreasing the tube current....
References
1. PetraliaG.,
BonelloL.,
ViottiS.et al.
(2010) CT perfusion in oncology: how to do it.Cancer Imaging 10: 8-19.
2. Cuenod C.
A.
et al.
(2006) Tumor angiogenesis: pathophysiology and implications for contrast-enhanced MRI and CT assessment.
Abdom Imaging 31:188–193.
3. Das CJ,
Thingujam U,
Panda A,
Sharma S,
Gupta AK.
(2015) Perfusion computed tomography in renal cell carcinoma.
World J Radiol 7(7): 170-179.
4. García-Figueiras et al.
(2013) CT Perfusion in Oncologic Imaging: A Useful Tool? AJR 200: 8–19.
5. M.
Ishida et al.
(2016) Underestimation...