Quantitative perfusion analysis of malignant liver tumors: dynamic computed tomography and contrast-enhanced ultrasound

Invest Radiol. 2012 Jan;47(1):18-24. doi: 10.1097/RLI.0b013e318229ff0d.

Abstract

Objective: To prospectively analyze the correlation between quantitative parameters of perfusion derived from dynamic contrast-enhanced CT (DCE-CT) and contrast-enhanced ultrasound (DCE-US) in patients with malignant liver tumors.

Materials and methods: Thirty patients (mean age: 59.4 ± 12.3 years) with primary malignant liver tumors or hepatic metastases of various origin underwent DCE-CT (4D spiral mode, scan range, 14.8 cm; 15 scans; cycle time, 3 seconds) and DCE-US (low mechanical index, <0.1, 2.4 mL microbubbles). DCE-CT and DCE-US images were evaluated by 2 radiologists regarding quantitative perfusion parameters including arterial liver perfusion (ALP), portal-venous perfusion (PVP), and total perfusion (P = ALP + PVP) from DCE-CT, as well as blood inflow velocity (B) and the normalized slope within the calculation range (CVan) from DCE-US.

Results: Quantitative assessment was possible with DCE-CT in 12/30 (40%) patients before and in all patients after automated motion correction. With DCE-US, quantitative assessment could not be performed in 9/30 (30.0%) patients due to respiratory motion. Interreader agreements for quantitative perfusion analysis were good with DCE-CT (r = 0.640-0.892, each P < 0.001) and DCE-US (r = 0.761-0.909, each P < 0.001). Moderate significant correlations were found between the perfusion parameters from DCE-CT (P, ALP) and DCE-US (B, CVan) (r = 0.446-0.621, each P < 0.05). No significant correlations were found between PVP from CT and perfusion parameters from DCE-US (B, CVan; each P = nonsignificant).

Conclusions: Quantitative evaluation of DCE-CT data was feasible in all patients after automated motion correction, whereas DCE-US data could not be quantitatively evaluated in 30% of patients due to respiratory motion and lack of motion correction software. Quantitative arterial perfusion analysis showed moderate significant correlations for blood flow parameters among modalities.

Publication types

  • Comparative Study

MeSH terms

  • Female
  • Humans
  • Liver Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • Perfusion Imaging / methods*
  • Phospholipids*
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Sulfur Hexafluoride*
  • Tomography, X-Ray Computed / methods*
  • Ultrasonography / methods*

Substances

  • Phospholipids
  • contrast agent BR1
  • Sulfur Hexafluoride