Dynamic contrast enhanced perfusion CT imaging: A diagnostic biomarker tool for survival prediction of tumour response to antiangiogenetic treatment in patients with advanced HCC lesions

Ippolito, Davide; Querques, Giulia; Okolicsanyi, S.; Franzesi, Cammillo Talei; Pecorelli, Anna; Lombardi, Sophie; Orsini, E.B.; Strazzabosco, Mario; Sironi, Sandro

doi:10.1016/j.ejrad.2018.07.012

Cited by 9 publications

(7 citation statements)

References 29 publications

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“…We retrospectively tested this theoretical framework on data obtained from abdominal perfusion studies performed in patients with advanced HCC who were candidate to anti-angiogenic therapy [ 3 ]. Time-enhancement curves were computed from ROIs on the HCC, the kidney cortex and pancreas, while a further ROI on the abdominal aorta allowed to compute its peak enhancement value and bolus shape (α).…”

Section: Discussionmentioning

confidence: 99%

“…We retrospectively analysed patients from a previously published study on the effects of anti-angiogenic therapy on the vascularity of HCC [ 3 ]. The study was approved by the Ethics Committee of ASST Monza–Ospedale San Gerardo (Monza, Italy) and all patients provided written informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…The measurement of organ perfusion carries a scientific and clinical relevance in many fields, such as the evaluation of the response of solid tumours to chemotherapy [ 1 ], including anti-angiogenic therapy in hepatocellular carcinoma (HCC) [ 2 , 3 ]; the differentiation between ischemic penumbra and infarct core in stroke [ 4 ], the diagnosis of cerebral vasospasm [ 5 ], and the assessment of myocardial ischemia [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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

Cressoni

Cozzi²,

Schiaffino³

et al. 2022

Eur Radiol Exp

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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 (r2 = 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 (r2 = 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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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Cressoni

Cozzi²,

Schiaffino³

et al. 2022

Eur Radiol Exp

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“…Indeed, the hemodynamic changing in the nodules through the development of carcinogenesis starts with decreasing the arterial supplies and presence of portal perfusion, after that the decreases on both arterial supplies and portal blood supplies would occur. Subsequently, the increase of arterial vascularity is developed, and the hypervascular pattern would appear [10]. Figure 1 shows the typical features for HCC in MRI and Figure 2 Shows a typical pattern of HCC in CT.…”

Section: Hcc Diagnosis In Ct and Mrimentioning

confidence: 99%

Multimodal Imaging of Hepatocellular Carcinoma Using Dynamic Liver Phantom

Ahmad¹,

Makhamrah²,

Hjouj³

2022

Hepatocellular Carcinoma - Challenges and Opportunities of a Multidisciplinary Approach

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Liver phantom is used at various medical levels, such as detecting hepatocellular carcinoma (HCC) in the early stages, training medical staff to deal with HCC by taking biopsies, developing new sequences on medical imaging devices, confirming the image quality, applying treatments to HCC, and others. All of the trials should be applied before entering the real human body. The phantom includes properties very similar to those of the human body, as well as the properties of liver cancer and how it is treated within the body through its biological form. Therefore, the present chapter aims to provide comprehensive information to consider when fabricating HCC-containing phantoms and the characteristics of those phantoms in proportion to multimodal medical imaging to aid in understanding the main target of dynamic phantom for HCC.

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“…HCC is the most common type of primary liver cancer, and is the most common cause of death among different cancers after lung cancer [ [1] , [2] , [3] ]. This cancer can be diagnosed using various modalities including ultrasound [ 4 ], computed tomography (CT) [ 5 , 6 ], and magnetic resonance imaging (MRI) [ 7 , 8 ]. The ability of these modalities to diagnose HCC is differentiated in its different stages where MRI is the best modality in diagnosing this disease.…”

Section: Introductionmentioning

confidence: 99%

Dynamic Hepatocellular Carcinoma Model Within a Liver Phantom for Multimodality Imaging

Ahmad

Suardi

Shukri

et al. 2020

European Journal of Radiology Open

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Introduction Hepatocellular carcinoma (HCC) is one of the most common cancer in the world, and the effectiveness of its treatment lies in its detection in its early stages. The aim of this study is to mimic HCC dynamically through a liver phantom and apply it in multimodality medical imaging techniques including magnetic resonance imaging (MRI), computed tomography (CT), and ultrasound. Methods and materials The phantom is fabricated with two main parts, liver parenchyma and HCC inserts. The liver parenchyma was fabricated by adding 2.5 wt% of agarose powder combined with 2.6 wt% of wax powder while the basic material for the HCC samples was made from polyurethane solution combined with 5 wt% glycerol. Three HCC samples were inserted into the parenchyma by using three cylinders implanted inside the liver parenchyma. An automatic injector is attached to the input side of the cylinders and a suction device connected to the output side of the cylinders. After the phantom was prepared, the contrast materials were injected into the phantom and imaged using MRI, CT, and ultrasound. Results Both HCC samples and liver parenchyma were clearly distinguished using the three imaging modalities: MRI, CT, and ultrasound. Doppler ultrasound was also applied through the HCC samples and the flow pattern was observed through the samples. Conclusion A multimodal dynamic liver phantom, with HCC tumor models have been fabricated. This phantom helps to improve and develop different methods for detecting HCC in its early stages.

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Dynamic contrast enhanced perfusion CT imaging: A diagnostic biomarker tool for survival prediction of tumour response to antiangiogenetic treatment in patients with advanced HCC lesions

Cited by 9 publications

References 29 publications

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

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

Multimodal Imaging of Hepatocellular Carcinoma Using Dynamic Liver Phantom

Dynamic Hepatocellular Carcinoma Model Within a Liver Phantom for Multimodality Imaging

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