Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs

Abstract Background Computed tomography perfusion imaging (CTPI) by repeated scanning has clinical relevance but implies relatively high radiation exposure. We present a method to measure perfusion from two CT scan phases only, considering tissue enhancement, feeding vessel (aortic) peak enhancement...

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Main Authors: Massimo Cressoni, Andrea Cozzi, Simone Schiaffino, Paolo Cadringher, Paolo Vitali, Gianpaolo Basso, Davide Ippolito, Francesco Sardanelli
Format: Article
Language:English
Published: SpringerOpen 2022-08-01
Series:European Radiology Experimental
Subjects:
Online Access:https://doi.org/10.1186/s41747-022-00292-y
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author Massimo Cressoni
Andrea Cozzi
Simone Schiaffino
Paolo Cadringher
Paolo Vitali
Gianpaolo Basso
Davide Ippolito
Francesco Sardanelli
author_facet Massimo Cressoni
Andrea Cozzi
Simone Schiaffino
Paolo Cadringher
Paolo Vitali
Gianpaolo Basso
Davide Ippolito
Francesco Sardanelli
author_sort Massimo Cressoni
collection DOAJ
description Abstract Background Computed tomography perfusion imaging (CTPI) by repeated scanning has clinical relevance but implies relatively high radiation exposure. We present a method to measure perfusion from two CT scan phases only, considering tissue enhancement, feeding vessel (aortic) peak enhancement, and bolus shape. Methods CTPI scans (each with 40 frames acquired every 1.5 s) of 11 patients with advanced hepatocellular carcinoma (HCC) enrolled between 2012 and 2016 were retrospectively analysed (aged 69 ± 9 years, 8/11 males). Perfusion was defined as the maximal slope of the time-enhancement curve divided by the peak enhancement of the feeding vessel (aorta). Perfusion was computed two times, first using the maximum slope derived from all data points and then using the peak tissue enhancement and the bolus shape obtained from the aortic curve. Results Perfusion values from the two methods were linearly related (r 2 = 0.92, p < 0.001; Bland–Altman analysis bias -0.12). The mathematical model showed that the perfusion ratio of two ROIs with the same feeding vessel (aorta) corresponds to their peak enhancement ratio (r 2 = 0.55, p < 0.001; Bland–Altman analysis bias -0.68). The relationship between perfusion and tissue enhancement is predicted to be linear in the clinical range of interest, being only function of perfusion, peak feeding vessel enhancement, and bolus shape. Conclusions This proof-of-concept study showed that perfusion values of HCC, kidney, and pancreas could be computed using enhancement measured only with two CT scan phases, if aortic peak enhancement and bolus shape are known.
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spelling doaj.art-6f7c9b6accbd45ebbdb10e8e32c7963d2022-12-22T04:24:05ZengSpringerOpenEuropean Radiology Experimental2509-92802022-08-016111210.1186/s41747-022-00292-yComputation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organsMassimo Cressoni0Andrea Cozzi1Simone Schiaffino2Paolo Cadringher3Paolo Vitali4Gianpaolo Basso5Davide Ippolito6Francesco Sardanelli7Unit of Radiology, IRCCS Policlinico San DonatoUnit of Radiology, IRCCS Policlinico San DonatoUnit of Radiology, IRCCS Policlinico San DonatoElekton S.A.S., Regione Crena 15AUnit of Radiology, IRCCS Policlinico San DonatoSchool of Medicine and Surgery, Università degli Studi di Milano-BicoccaSchool of Medicine and Surgery, Università degli Studi di Milano-BicoccaUnit of Radiology, IRCCS Policlinico San DonatoAbstract Background Computed tomography perfusion imaging (CTPI) by repeated scanning has clinical relevance but implies relatively high radiation exposure. We present a method to measure perfusion from two CT scan phases only, considering tissue enhancement, feeding vessel (aortic) peak enhancement, and bolus shape. Methods CTPI scans (each with 40 frames acquired every 1.5 s) of 11 patients with advanced hepatocellular carcinoma (HCC) enrolled between 2012 and 2016 were retrospectively analysed (aged 69 ± 9 years, 8/11 males). Perfusion was defined as the maximal slope of the time-enhancement curve divided by the peak enhancement of the feeding vessel (aorta). Perfusion was computed two times, first using the maximum slope derived from all data points and then using the peak tissue enhancement and the bolus shape obtained from the aortic curve. Results Perfusion values from the two methods were linearly related (r 2 = 0.92, p < 0.001; Bland–Altman analysis bias -0.12). The mathematical model showed that the perfusion ratio of two ROIs with the same feeding vessel (aorta) corresponds to their peak enhancement ratio (r 2 = 0.55, p < 0.001; Bland–Altman analysis bias -0.68). The relationship between perfusion and tissue enhancement is predicted to be linear in the clinical range of interest, being only function of perfusion, peak feeding vessel enhancement, and bolus shape. Conclusions This proof-of-concept study showed that perfusion values of HCC, kidney, and pancreas could be computed using enhancement measured only with two CT scan phases, if aortic peak enhancement and bolus shape are known.https://doi.org/10.1186/s41747-022-00292-yTomography (x-ray computed)Contrast mediaPerfusion imagingCarcinoma (hepatocellular)
spellingShingle Massimo Cressoni
Andrea Cozzi
Simone Schiaffino
Paolo Cadringher
Paolo Vitali
Gianpaolo Basso
Davide Ippolito
Francesco Sardanelli
Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
European Radiology Experimental
Tomography (x-ray computed)
Contrast media
Perfusion imaging
Carcinoma (hepatocellular)
title Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
title_full Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
title_fullStr Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
title_full_unstemmed Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
title_short Computation of contrast-enhanced perfusion using only two CT scan phases: a proof-of-concept study on abdominal organs
title_sort computation of contrast enhanced perfusion using only two ct scan phases a proof of concept study on abdominal organs
topic Tomography (x-ray computed)
Contrast media
Perfusion imaging
Carcinoma (hepatocellular)
url https://doi.org/10.1186/s41747-022-00292-y
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