Purpose
INTRODUCTIONAn increasing number of vascular-modulating drugs are used in the treatment of cancers, which in turn increase demand for noninvasive methods of assessing tumor vascularity in vivo.Perfusion CT is a new technology that allows measurement of tumor vascular physiology .Apart from being noninvasive and fast, it can be repeated at regular intervals to assess tumor response to antiangiogenic therapy.Here we present a futuristic clinical applications of perfusion CT using 64 slice MDCT scanner.AIMS AND OBJECTIVESEvaluation of the role of computed tomography perfusion (CTP) examination for...
Methods and Materials
402lesions prospectively studied from January to Dec 2008.98 head and neck pathologies26 esophageal pathologies142 lung pathologies101 abdominal pathologies42 pelvic pathologiesOf which 33 previously untreated patients with H& N , abdominal , lung and esophageal malignancies (25 males, 8 females, aged 47-69 years) which had lymphnodal metastasis were included in the study.CT perfusion was performed with a 64 –slice MDCT. Tumor was localized and a 4-cm lesions region was selected independently for the dynamic study . Contrast bolus infusion at a rate of 50 mL at...
Results
Good agreements were obtained between the replicated measurements (interclass correlation coefficient > 0.99)When compared to normal, benign lesions showed higher BF and BV but were not statistically significant(p >0.05). MTT and TTP values in benign lesions were comparable to that of normal.On the perfusion maps, malignant nodes showed remarkable hypoperfusion compared to non-malignant ones.Except for MTT and TTP, which were statistically (p <0.05) lower in malignant lesions, all CTP parameter values were significantly (P <0 .05) higher in malignant nodes when compared with the benign...
Conclusion
Finally we conclude, CTP provides additional functional information regarding characterization of lymph nodes.It might be useful in differentiation between malignant and non-malignant lymph nodes; however, this study requires further validation.Therefore perfusion CT tool may be helpful in oncology, providing a higher degree of diagnosis security, differentiation in malignancy and for the therapeutical follow-upOne of the important applications of this technique is the indication of a highly perfused node, which could be used to guide biopsy and thus reducing the chance of sampling error.
References
Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 1971;285:1182–1186. Tuncbilek N, Karakas HM, Altaner S. Dynamic MRI in indirect estimation of MVD, histologic grade, and prognosis in colorectal adenocarcinomas. Abdom Imaging. 2004;29:166–172. Roberts HC, Roberts TP, Lee TY, Dillon W. Dynamic, contrast-enhanced CT of human brain tumors: quantitative assessment of blood volume, blood flow, and microvascular permeability. AJNR Am J Neuroradiol. 2002;23:828–832. Blomley MJ, Coulden R, Bufkin C, Lipton MJ, Dawson P. Contrast bolus dynamic computed tomography for the measurement of solid organ...
Personal Information
Author details:Dr. Abhishek Mahajan, MBBS,MDFellow in Cancer ImagingDept of Radiodiagnosis & ImagingTata Memorial HospitalDr E Borges RoadParelMumbaiMaharashtra400 012India(+919920354764)
[email protected]