Feasibility of integrated CT-liver perfusion in routine FDG-PET/CT.

Abstract

OBJECTIVE:

To integrate CT-perfusion into a routine, clinical contrast-enhanced (ce) PET/CT protocol for the evaluation of liver metastases and to compare functional CT and PET parameters.

MATERIALS AND METHODS:

Forty-six consecutive patients (mean age: 60 (34-82) years; 20 f, 26 m) with known liver lesions (colorectal metastases (n = 34), primary liver cancer (n = 4), breast cancer (n = 3), anal cancer, gastric cancer, esophageal cancer, GIST, duodenal cancer (all: n = 1) who were referred for staging or therapy follow-up by [18F]-Fluoro-2-deoxy-D-glucose-positron-emission-tomography/computed-tomography imaging (FDG-PET/CT) were included. After acquisition of a low-dose PET/CT, a split-injection (70-90 mL) ce-CT-protocol, including a 35-s CT-perfusion scan of the liver and a diagnostic ce-CT of the thorax and/or abdomen (70 s delay, iv-contrast volume: 90 mL, 4 mL/s) was performed. CT-perfusion parameters (BF, BV, MTT,) and semi-quantitative PET-parameters (SUVmax, SUVmean, TLG, PETvol) were analyzed and compared.

RESULTS:

CT-perfusion data could be obtained in all but one patient with shallow breathing. In all patients, diagnostic ce-PET/CT quality was adequate without the use of additional contrast media. Significant correlations (P < 0.05) were found for each of BF, BV, MTT, and SUVmax, further, BF and MTT correlated with TLG. Several other correlations were seen for other perfusion and PET-parameters.

CONCLUSION:

Combined CT-perfusion/PET/CT-protocol without the use of additional contrast media is feasible and can be easily integrated in clinical routine. Perfusion parameters and PET-parameters are only partly correlating and therefore have to be investigated further at fixed time points during the course of disease and therapy.

• Authors: Patrick Veit-Haibach, Valerie Treyer, Klaus Strobel, Jan D Soyka, Lars Husmann, Niklaus G Schaefer, Alois Tschopp, Thomas F Hany
• Journal: Abdominal imaging (Abdom Imaging) Vol. 35 Issue 5 Pg. 528-36 (Oct 2010) ISSN: 1432-0509 [Electronic] United States
• PMID: 19593563 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Contrast Media
• Radiopharmaceuticals
• Fluorodeoxyglucose F18
• Iohexol
• iopromide

Topics

• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Breast Neoplasms (pathology)
• Contrast Media
• Feasibility Studies
• Female
• Fluorodeoxyglucose F18
• Gastrointestinal Neoplasms (pathology)
• Humans
• Iohexol (analogs & derivatives)
• Liver Neoplasms (diagnostic imaging, drug therapy, secondary)
• Male
• Middle Aged
• Neoplasm Staging
• Perfusion Imaging (methods)
• Positron-Emission Tomography (methods)
• Radiographic Image Interpretation, Computer-Assisted
• Radiopharmaceuticals
• Statistics, Nonparametric
• Tomography, X-Ray Computed (methods)