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01-09-2016 | Computed Tomography

Iodine concentration as a perfusion surrogate marker in oncology: Further elucidation of the underlying mechanisms using Volume Perfusion CT with 80 kVp

Authors: Wolfgang M. Thaiss, Ulrike Haberland, Sascha Kaufmann, Daniel Spira, Christoph Thomas, Konstantin Nikolaou, Marius Horger, Alexander W. Sauter

Published in: European Radiology | Issue 9/2016

Abstract

Objectives

To assess the value of iodine concentration (IC) in computed tomography data acquired with 80 kVp, as a surrogate for perfusion imaging in hepatocellular carcinoma (HCC) and lymphoma by comparing iodine related attenuation (IRA) with quantitative Volume Perfusion CT (VPCT)-parameters.

Methods

VPCT-parameters were compared with intra-tumoral IC at 5 time points after the aortic peak enhancement (APE) with a temporal resolution of 3.5 sec in untreated 30 HCC and 30 lymphoma patients.

Results

Intra-tumoral perfusion parameters for HCC showed a blood flow (BF) of 52.7 ± 17.0 mL/100 mL/min, blood volume (BV) 12.6 ± 4.3 mL/100 mL, arterial liver perfusion (ALP) 44.4 ± 12.8 mL/100 mL/min. Lesion IC 7 sec after APE was 133.4 ± 57.3 mg/100 mL. Lymphoma showed a BF of 36.8 ± 13.4 mL/100 mL/min, BV of 8.8 ± 2.8 mL/100 mL and IC of 118.2 ± 64.5 mg/100 mL 3.5 sec after APE. Strongest correlations exist for VPCT-derived BF and ALP with IC in HCC 7 sec after APE (r = 0.71 and r = 0.84) and 3.5 sec after APE in lymphoma lesions (r = 0.77). Significant correlations are also present for BV (r = 0.60 and r = 0.65 for HCC and lymphoma, respectively).

Conclusions

We identified a good, time-dependent agreement between VPCT-derived flow values and IC in HCC and lymphoma. Thus, CT-derived ICs 7 sec after APE in HCC and 3.5 sec in lymphoma may be used as surrogate imaging biomarkers for tumor perfusion with 80 kVp.

Key points

• Iodine concentration derived from low kVp CT is regarded as perfusion surrogate

• Correlation with Perfusion CT was performed to elucidate timing and histology dependencies

• Highest correlation was present 7 sec after aortic peak enhancement in hepatocellular carcinoma

• In lymphoma, highest correlation was calculated 3.5 sec after aortic peak enhancement

• With these results, further optimization of Dual energy CT protocols is possible

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Title: Iodine concentration as a perfusion surrogate marker in oncology: Further elucidation of the underlying mechanisms using Volume Perfusion CT with 80 kVp
Authors: Wolfgang M. Thaiss
Ulrike Haberland
Sascha Kaufmann
Daniel Spira
Christoph Thomas
Konstantin Nikolaou
Marius Horger
Alexander W. Sauter
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: European Radiology / Issue 9/2016
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-015-4154-9

At a glance: The STEP trials

Springer Medicine

Iodine concentration as a perfusion surrogate marker in oncology: Further elucidation of the underlying mechanisms using Volume Perfusion CT with 80 kVp

Abstract

Objectives

Methods

Results

Conclusions

Key points

At a glance: The STEP trials

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Key points

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