Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases.

Abstract

The purpose of this study was to evaluate the feasibility of a total-liver-volume perfusion CT (CTP) technique for the detection and characterization of liver metastases. Twenty patients underwent helical CT of the total liver volume before and 11 times after intravenous contrast-material injection. To decrease distortion artifacts, all phases were co-registered using 3-D image fusion before creating blood-flow maps. Lesion-based sensitivity and specificity for liver metastases of first the conventional four phases (unenhanced, arterial, portal venous, and equilibrium) and later all 12 phases including blood-flow maps were determined as compared to intraoperative ultrasound and surgical exploration. Arterial and portal venous perfusion was calculated for normal-appearing and metastatic liver tissue. Total-liver-volume perfusion values were comparable to studies using single-level CTP. Compared to four-phase CT, total -liver-volume CTP increased sensitivity to 89.2 from 78.4% (P=0.046) and specificity to 82.6 from 78.3% (P=0.074). Total -liver-volume CTP is a noninvasive, quantitative, and feasible technique. Preliminary results suggest an improved detection of liver metastases for CTP compared to four-phase CT.

• Authors: Martijn R Meijerink, Jan Hein T M van Waesberghe, Lineke van der Weide, Petrousjka van den Tol, Sybren Meijer, Cornelis van Kuijk
• Journal: European radiology (Eur Radiol) Vol. 18 Issue 10 Pg. 2345-54 (Oct 2008) ISSN: 0938-7994 [Print] Germany
• PMID: 18491094 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Algorithms
• Female
• Humans
• Imaging, Three-Dimensional (methods)
• Liver (blood supply, diagnostic imaging)
• Liver Neoplasms (diagnostic imaging, secondary)
• Male
• Middle Aged
• Neovascularization, Pathologic (diagnostic imaging)
• Radiographic Image Enhancement (methods)
• Radiographic Image Interpretation, Computer-Assisted (methods)
• Reproducibility of Results
• Sensitivity and Specificity
• Tomography, X-Ray Computed (methods)