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- Title
Can dual-energy CT replace perfusion CT for the functional evaluation of advanced hepatocellular carcinoma?
- Authors
Mulé, Sébastien; Pigneur, Frédéric; Quelever, Ronan; Tenenhaus, Arthur; Baranes, Laurence; Richard, Philippe; Tacher, Vania; Herin, Edouard; Pasquier, Hugo; Ronot, Maxime; Rahmouni, Alain; Vilgrain, Valérie; Luciani, Alain
- Abstract
<bold>Objectives: </bold>To determine the degree of relationship between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT parameters in patients with advanced HCC under treatment.<bold>Methods: </bold>In this single-centre IRB approved study, 16 patients with advanced HCC treated with sorafenib or radioembolization who underwent concurrent dynamic perfusion CT and multiphase DECT using a single source, fast kV switching DECT scanner were included. Written informed consent was obtained for all patients. HCC late-arterial and portal iodine concentrations, blood flow (BF)-related and blood volume (BV)-related perfusion parameters maps were calculated. Mixed-effects models of the relationship between iodine concentrations and perfusion parameters were computed. An adjusted p value (Bonferroni method) < 0.05 was considered significant.<bold>Results: </bold>Mean HCC late-arterial and portal iodine concentrations were 22.7±12.7 mg/mL and 18.7±8.3 mg/mL, respectively. Late-arterial iodine concentration was significantly related to BV (mixed-effects model F statistic (F)=28.52, p<0.0001), arterial BF (aBF, F=17.62, p<0.0001), hepatic perfusion index (F=28.24, p<0.0001), positive enhancement integral (PEI, F=66.75, p<0.0001) and mean slope of increase (F=32.96, p<0.0001), while portal-venous iodine concentration was mainly related to BV (F=29.68, p<0.0001) and PEI (F=66.75, p<0.0001).<bold>Conclusions: </bold>In advanced HCC lesions, DECT-derived late-arterial iodine concentration is strongly related to both aBF and BV, while portal iodine concentration mainly reflects BV, offering DECT the ability to evaluate both morphological and perfusion changes.<bold>Key Points: </bold>• Late-arterial iodine concentration is highly related to arterial BF and BV. • Portal iodine concentration mainly reflects tumour blood volume. • Dual-energy CT offers significantly decreased radiation dose compared with perfusion CT.
- Subjects
COMPUTED tomography; MAGNETIC resonance imaging; HEPATITIS B virus; MEDICAL care; CANCER invasiveness; DIAGNOSTIC imaging; GROWTH factors; HEPATOCELLULAR carcinoma; IODINE; LIVER; LIVER tumors; LONGITUDINAL method; PERFUSION; RADIONUCLIDE imaging; RESEARCH evaluation; CONTRAST media
- Publication
European Radiology, 2018, Vol 28, Issue 5, p1977
- ISSN
0938-7994
- Publication type
journal article
- DOI
10.1007/s00330-017-5151-y