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ECR 2010 / C-3428
Perfusion CT: A Pictorial Review from Head to Prostate
Congress: ECR 2010
Poster No.: C-3428
Type: Educational Exhibit
Topic: Molecular Imaging - Your latest results
Keywords: Molecular imaging
Authors: A. Mahajan1, V. R. K. Rao2; 1Mumbai/IN, 2MANIPAL/IN
DOI:10.1594/ecr2010/C-3428

Imaging findings OR Procedure details

467 lesions prospectively studied from January to Dec 2008.

 

36 brain lesions

98 head and neck pathologies

11 spinal pathologies

11 breast malignancies

26  esophageal pathologies

142 lung pathologies

101 abdominal pathologies

42 pelvic pathologies

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 5 mL/sec for 10 seconds, followed by a saline flush at 40 mL at 5mL/sec for 8 seconds.

 

Total 30 dynamic acquisitions with inter - cycle interval 2sec and total scan time 60 seconds.

 

Followed by routine contrast-enhanced scan. This scan was used for routine cancer diagnosis.

 

We used maximum slope analytical model method, yielding five  major kinetic parameters:

 

(1) Perfusion (measured in ml/min/ml);

(2) Peak enhancement intensity (PEI, measured in HU);

(3) Time to peak (TTP, measured in s);

(4) Blood volume (BV, measured in ml/100 g);

(5)Mean transit time (MTT) (sec),

 

Along with colour maps of the five kinetic parameters, time attenuation curves (TACs) for the input artery and tumour were generated.

 

RESULTS 

 

Good agreements were obtained between the replicated measurements (interclass correlation coefficient > 0.99)

 

Except for MTT and TTP, which was statistically (p <0.05) lower in malignant lesions, all CTP parameter values were significantly (P <0 .05) higher in malignant lesions when compared with the benign lesions and the background normal tissue.

 

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.

 

BRAIN PATHOLOGIES (n=36)

18 cases of stroke

14 brain tumors

9 cases of pituitary adenoma

6 infective lesions

 

HEAD & NECK PATHOLOGIES (n=98)

14 cases of Salivary gland lesions

24 cases of Buccal malignancies

9 cases of Supraglottic ca’s

11 cases of Glottic ca’s

4 cases of Infraglottic ca’s

8 cases of Thyroid lesions

15 cases of Lymphnodal lesions

13 cases of Neck infections

 

ESOPHAGEAL MALIGNANCIES (n=26)

7 cases of Cervical esophagus

11 cases of Thoracic esophagus

8 cases of Gastroesophageal junction

 

BREAST MALIGNANCIES (n=11)

9 cases of female breast ca’s

2 cases of male breast ca’s

 

LUNG PATHOLOGIES (n=142)

98 cases of lung malignancies

54 cases of benign lung lesions

 

SPINAL PATHOLOGIES (n=11)

7 cases of spinal malignancies

4 cases of benign spinal lesions

 

ABDOMINALPATHOLOGIES (n=101)

9 cases of Gastric malignancies

21 cases of Hepatic lesions

19 cases of Pancreatic lesions

2 cases of Splenic lesions

9 cases of small bowel malignancies

4 cases of Adrenal lesions

9 cases of Renal lesions

13 cases of Colonic malignancies

16 cases of Lymphomas

 

PELVIC PATHOLOGIES (n=42)

6 cases of urinary bladder malignancies

13 cases of rectal malignancies

6 cases of cervical malignancies

4 cases of uterine malignancies

7 cases of ovarian lesions

5 cases of prostatic malignancies

1 cases of skin malignancy

 

We observed that in our series many malignant tumors show clear perfusion changes that may be helpful for differentiation from benign tumors.

 

Although our experience is limited, we believe that perfusion CT can reveal blood flow in cases with malignancy and therefore may aid in the differentiation of the late stage fibrosis and recurrent tumor in many cases.

 

 

 

 

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