Abstract

Objective: The purpose of this study was to determine how the slice thickness reconstruction influences quantitative perfusion CT parameters. Materials and Methods: Eighteen patients with cancer (15 non-small-cell lung cancer, 2 rectal cancer and 1 renal cancer) were examined prospectively with multidetector row CT. A 90-second perfusion study was performed after intravenous bolus injection of contrast material. Blood flow, blood volume, mean transit time and permeability-surface area product were determined at three different slice thickness reconstruction (1.25, 2.5 and 5 mms) both in tumors and in paraspinal muscle. Mean values, limits of agreement between measurements and within-subject coefficient of correlation were obtained for these thicknesses. Results: Mean ± standard deviation BF, BV, MTT and PS in lesions were 118.7 ± 117.9 mL/min/100g tissue, 8.2 ± 8.2 mL/100g tissue, 7.5 ± 5.4 seconds and 10.3 ± 7.2 mL/min/100g tissue respectively at1.25 mmslice thickness; 116.1 ± 115.7 mL/min/100g tissue, 7.8 ± 8.7 mL/100g tissue, 7 ± 4.5 seconds and 10.4 ± 7.5 mL/min/100g tissue at 2.5 mms; and 119.6 ± 115.7 mL/min/100g tissue, 7.8 ± 8.8 mL/100g tissue, 5.4 ± 3.4 seconds and 9.6 ± 7.5 mL/min/100g tissue at 5 mms. Differences between means for different slice thickness where relatively small in all parameters (<15%) except in MTT where difference was up to 37%. 95% limits of agreement were worse when comparing more different slice thicknesses (e.g. 1.25 vs 5 mms) than when comparing more close slice thicknesses (1.25 vs 2.5 mms or 2.5 vs 5 mms). Conclusions: There is a significant variability in perfusion parameter measurements at different slice thickness reconstruction, particularly in MTT. The more close together the slice thicknesses were, the smaller was the variability.

Highlights

  • Computed tomography has become the main diagnostic tool in staging and monitoring the response to therapy of many tumours due to its relative low cost and wide availability

  • The mean values obtained in the paraspinous muscles were significantly lower when compared with the tumor tissue for all perfusion parameters, except for the mean transit time (MTT) where the values were higher in muscles than in tumor

  • Differences between means for different slice thickness were relatively small in all parameters except in MTT, were means varied from 7.5 secs at 1.25 mms to 5.45 secs at 5 mms in tumours, and from 11.2 secs at blood flow (BF) blood volume (BV) MTT

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Summary

Introduction

Computed tomography has become the main diagnostic tool in staging and monitoring the response to therapy of many tumours due to its relative low cost and wide availability. Perfusion CT is a rapidly developing technique that allows functional evaluation of tissue vascularity [1] It was developed 30 years ago, primarily for quantification of cerebral blood perfusion in patients with acute stroke [2], but the recent availability of MDCT scanners with a higher number of detector rows that allow greater anatomic coverage and higher temporal resolution, has rediscovered the technique as a promising noninvasive tool for evaluation of the microcirculatory changes associated with several neoplasms. The increasing interest in oncologic applications of perfusion CT has been fueled by the widely recognized limitations of morphologic assessment of treatment response. These limitations are evident with novel antiangiogenic agents, that are tipically not citotoxic but instead produce disease stabilization [3]. Reported clinical uses of perfusion CT include differentiation between benign and malignant lesions, tumor characterization, prognostic biomarker and monitoring therapy

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