Perfusion CT Imaging of Brain Tumors: An Overview

Jain, Rajan

doi:10.3174/ajnr.a2263

Cited by 84 publications

(47 citation statements)

References 35 publications

(43 reference statements)

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“…Most perfusion imaging studies that evaluated the relationships between tumor perfusion parameters and overall survival (OS) have focused on MR perfusion imaging at a single time point [14] or two time points [15]. CT perfusion has not been studied extensively despite the ubiquity of CT scanners [16]. However, CT perfusion can help distinguish between high and low grade gliomas [7,[17][18][19] and between tumor recurrence and radiation necrosis [20,21].…”

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confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

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Patients with high-grade gliomas usually have heterogeneous response to surgery and chemoirradiation. The objectives of this study were (1) to evaluate serial changes in tumor volume and perfusion imaging parameters and (2) to determine the value of these data in predicting overall survival (OS). Twenty-nine patients with World Health Organization grades III and IV gliomas underwent magnetic resonance (MR) and computed tomography (CT) perfusion examinations before surgery, and 1, 3, 6, 9, and 12 months after radiotherapy. Serial measurements of tumor volumes and perfusion parameters were evaluated by receiver operating characteristic analysis, Cox proportional hazards regression, and Kaplan-Meier survival analysis to determine their values in predicting OS. Higher trends in blood flow (BF), blood volume (BV), and permeability-surface area product in the contrast-enhancing lesions (CEL) and the non-enhancing lesions (NEL) were found in patients with OS \ 18 months compared to those with OS C 18 months, and these values were significant at selected time points (P \ 0.05). Only CT perfusion parameters yielded sensitivities and specificities of C70 % in predicting 18 and 24 months OS. Pre-surgery BF in the NEL and BV in the CEL and NEL 3 months after radiotherapy had sensitivities and specificities [80 % in predicting 24 months OS in patients with grade IV gliomas. Our study indicated that CT perfusion parameters were predictive of survival and could be useful in assessing early response and in selecting adjuvant treatment to prolong survival if verified in a larger cohort of patients.

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confidence: 99%

Survival prediction in high-grade gliomas using CT perfusion imaging

Yeung

Wang

et al. 2015

J Neurooncol

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“…CT perfusion parameters, BF and BV, reflect the state of dynamic perfusion and blood volume in local tissue respectively (Jain, 2011). BV, in particular, is directly related to the area of local vascular bed (Leiva-Salinas et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Clinical Study of Tumor Angiogenesis and Perfusion Imaging Using Multi-slice Spiral Computed Tomography for Breast Cancer

Xu¹,

Lei²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Objectives: To explore the correlation between multi-slice spiral CT (MSCT) perfusion parameters and the expression of vascular endothelial growth factor (VEGF) as well as matrix metalloproteinase-2 (MMP-2) in breast cancer. Methods: Forty five breast cancer patients and 16 patients with benign breast tumor, both confirmed by pathology examination, were enrolled. All underwent MSCT perfusion imaging to obtain perfusion maps and data for parameters including blood flow (BF), blood volume (BV) and permeability surface (PS). Cancer patients did not receive treatment prior to surgery. The expression of VEGF and MMP-2 were examined with both immunohistochemistry and Western blotting. Results: The levels of VEGF and MMP-2 by immunohistochemistry were significantly higher in the breast cancer group (P < 0.01) than the benign tumor group. Relative OD values from Western blotting were also higher in cancer cases (P < 0.05). Similarly, the mean MSCT perfusion parameters (BF, BV, PS) were significantly higher in the breast cancer group (P < 0.01), BF and BV positively correlating with VEGF expression (r = 0.878 and 0.809 respectively, P < 0.01); PS and VEGF and MMP-2 expression were also positively correlated (r= 0.860, 0.786 respectively, P < 0.01). Conclusion: There is a correlation between breast cancer MSCT perfusion parameters and VEGF andMMP-2 expression, which might be useful for detection of breast lesions, qualitative diagnosis of breast cancer, and evaluation of breast cancer treatment.

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“…In brain tumors where considerable amount of contrast can leak into the interstitial space, the susceptibility-contrast signal intensity loss can be masked by the competing T1 effects [6]. DSC-MR measurement leads to an underestimation of BV if it is not addressed by (1) pre-saturating the brain parenchyma with a pre-loading dose of contrast, (2) dual-echo sequence, or (3) post-processing correction [6,42]. This effect also makes the quantification of tumor permeability technically challenging.…”

Section: Discussion: Strengths and Challenges Of Pctmentioning

confidence: 99%

“…On the other hand, the moderate PS observed in TIN is likely mediated by the release of VEGF in the pathogenesis of radiation necrosis [41]. In addition, susceptibility artefacts from blood products (hemorrhage, thrombus) and calcification can potentially complicate the analysis of DSC-MR studies while PCT is not affected by these artefacts [39,42].…”

Section: Differentiation Of True Progression From Post-treatment Effectsmentioning

confidence: 99%