Intraobserver and Interobserver Agreement in the Evaluation of Tumor Vascularization With Computed Tomography Perfusion in Cirrhotic Patients With Hepatocellular Carcinoma

Ippolito, Davide; Casiraghi, Alessandra; Franzesi, Cammillo Talei; Bonaffini, Pietro Andrea; Fior, Davide; Sironi, Sandro

doi:10.1097/rct.0000000000000331

Cited by 8 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It should be mentioned that our study has some limitations. We did perform consensus reading instead interreader evaluation of results [37]. There are several software with different underlying calculation models available and evaluation of the reading performance with different software/models was beyond the scope of our initial evaluation [38, 39].…”

Section: Discussionmentioning

confidence: 99%

CT-perfusion in peripheral arterial disease – Correlation with angiographic and hemodynamic parameters

et al. 2019

View full text Add to dashboard Cite

ObjectiveThe purpose of this study was the assessment of volumetric CT-perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) of the lower extremities, comparing it with established angiographic and hemodynamic parameters.Materials and methodsThirty-five consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularization were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment. Hemodynamic parameters, specifically ankle-brachial pressure index (ABI), ankle blood pressure (ABP), peak systolic velocity (PSV), and segmental pulse oscillography (SPO) level, were determined. Lesion length and degree of collateralization were assessed by interventional angiography. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters and correlations between CTP, hemodynamic and angiographic parameters were assessed with non-parametric tests.ResultsThe cohort consisted of 27 subjects with an occlusion, and eight with a high-grade stenosis. The mean blood flow (BF) was 7.71 ± 2.96 ml/100ml*min-1, mean blood volume (BV) 0.71 ± 0.33 ml/100ml, and mean mean transit time (MTT) 7.22 ± 2.66 s. BF and BV were higher in subjects with longer lesions, and BV was higher in subjects with lower ABI. Significant correlations were found between lesion length and BV (r = 0.65) and BF (r = 0.52). Significant inverse correlations were found between BV and ABI and between BV and ABP (r = -0.56, for both correlations).ConclusionsIn our study, we have shown the feasibility of CTP for the assessment of PAD. In the future, this quantitative method might serve as a non-invasive method, possibly complementing the diagnostic workup of patients with peripheral arterial disease.

show abstract

Section: Discussionmentioning

confidence: 99%

CT-perfusion in peripheral arterial disease – Correlation with angiographic and hemodynamic parameters

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Some limitations of our study deserve to be mentioned. We did perform consensus reading of results [ 21 ]. Patients with stenosis and occlusions were not evaluated separately due to the low number of individuals in the stenosis subgroup.…”

Section: Discussionmentioning

confidence: 99%

CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

et al. 2021

View full text Add to dashboard Cite

Objectives The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation. Methods Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests. Results The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min−1. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively). Conclusions CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease. Key Points • CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients. • This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

show abstract

“…Previous evaluations of observer variability in CTp have been undertaken in the brain 4 –6 and for tumors in a variety of body locations. 7 –11 The lung is a major site for primary and metastatic tumors. 12 Unlike evaluations in the brain, lesions in body locations are susceptible to motion (breathing, cardiac movement, etc), which imposes additional challenges in delineating ROIs.…”

Section: Introductionmentioning

confidence: 99%

Observer Variability in CT Perfusion Parameters in Primary and Metastatic Tumors in the Lung

Wei

Ghosh

et al. 2018

Technol Cancer Res Treat

View full text Add to dashboard Cite

Purpose:Evaluate observer variability in computed tomography perfusion measurements in lung tumors and assess the relative contributions of individual factors to overall variability.Materials and Methods:Four observers independently delineated tumor and defined arterial input function region of interests (tumor region of interest and arterial input function region of interest) on each of 4 contiguous slice levels of computed tomography perfusion images (arterial input function level), in 12 computed tomography perfusion data sets containing lung tumors (>2.5 cm size), on 2 separate occasions. Computed tomography perfusion parameters (blood flow, blood volume, mean transit time, and permeability surface area product) for tumor volumes of interest were computed for all combinations of these factors, totaling up to 1024 combinations per patient. Overall, inter- and intraobserver variability were assessed by within-patient coefficient of variation, variance components analyses, and intraclass correlation.Results:Overall observer within-patient coefficient of variations for tumor blood flow, blood volume, mean transit time, and permeability surface area product were 20.3%, 11.9%, 6.3%, and 31.7%, and intraclass correlations were 0.94, 0.91, 0.82, and 0.72, respectively. Interobserver tumor volume of interest and arterial input function level were the highest contributors to overall variance for blood flow, blood volume, and mean transit time. Overall intraobserver wCVs for blood flow, blood volume, mean transit time, and permeability surface area product (4.3%, 2.4%, 0.9%, and 3.1%) were smaller than interobserver within-patient coefficient of variations (9.5%, 5.6%, 1.6%, and 7.0%), respectively.Conclusion:The largest contributors to observer variability were interobserver tumor volume of interest and arterial input function level. Overall variability in computed tomography perfusion studies can potentially be minimized by using a single observer and a consistent level for arterial input function, which would be important considerations in longitudinal and multicenter studies. Methods to reliably define arterial input function and delineate tumor volumes would help to reduce variability in estimations of computed tomography perfusion parameter values.

show abstract

Intraobserver and Interobserver Agreement in the Evaluation of Tumor Vascularization With Computed Tomography Perfusion in Cirrhotic Patients With Hepatocellular Carcinoma

Abstract: For all Perf parameters intra-agreement was higher than interagreement, even though a relatively wide range of 95% limits of agreement was found in both cases.

Cited by 8 publications

References 26 publications

CT-perfusion in peripheral arterial disease – Correlation with angiographic and hemodynamic parameters

CT-perfusion in peripheral arterial disease – Correlation with angiographic and hemodynamic parameters

CT perfusion in peripheral arterial disease—hemodynamic differences before and after revascularisation

Observer Variability in CT Perfusion Parameters in Primary and Metastatic Tumors in the Lung

Contact Info

Product

Resources

About