Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases

Meijerink, Martijn R.; Waesberghe, J.H.T.M. van; Weide, Lineke van der; Tol, Petrousjka van den; Meijer, Sybren; Kuijk, Cornelis van

doi:10.1007/s00330-008-0996-8

Cited by 62 publications

(31 citation statements)

References 32 publications

(41 reference statements)

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“…Thus theoretically, fusion imaging of ultrasound and CT/MRI is helpful to locate and detect those inconspicuous lesions, which would facilitate the following ultrasound-guided interventional procedures. [28][29][30][31][32][33] In this series, for those 45 inconspicuous lesions on conventional ultrasound, 53.3% could be detected on ultrasound-CECT/ CEMRI fusion imaging, whereas 93.3% lesions could be detected through CEUS and CECT/CEMRI fusion imaging. The number of the conspicuous lesions on conventional ultrasound, ultrasound-CECT/CEMRI fusion imaging and CEUS and CECT/CEMRI fusion imaging accounted for 35.7%, 70.0% and 95.7%, respectively, of the total target lesions.…”

Section: Discussionmentioning

confidence: 60%

Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

Wang

et al. 2016

BJR

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Objective: To investigate the usefulness of fusion imaging of contrast-enhanced ultrasound (CEUS) and CECT/ CEMRI before percutaneous ultrasound-guided radiofrequency ablation (RFA) for liver cancers. Methods: 45 consecutive patients with 70 liver lesions were included between March 2013 and October 2015, and all the lesions were identified on CEMRI/CECT prior to inclusion in the study. Planning ultrasound for percutaneous RFA was performed using conventional ultrasound, ultrasound-CECT/CEMRI and CEUS and CECT/CEMRI fusion imaging during the same session. The numbers of the conspicuous lesions on ultrasound and fusion imaging were recorded. RFA was performed according to the results of fusion imaging. Complete response (CR) rate was calculated and the complications were recorded. Results: On conventional ultrasound, 25 (35.7%) of the 70 lesions were conspicuous, whereas 45 (64.3%) were inconspicuous. Ultrasound-CECT/CEMRI fusion imaging detected additional 24 lesions thus increased the number of the conspicuous lesions to 49 (70.0%) (70.0% vs 35.7%; p , 0.001 in comparison with conventional ultrasound). With the use of CEUS and CECT/CEMRI fusion imaging, the number of the conspicuous lesions further increased to 67 (95.7%, 67/70) (95.7% vs 70.0%, 95.7% vs 35.7%; both p , 0.001 in comparison with ultrasound and ultrasound-CECT/CEMRI fusion imaging, respectively). With the assistance of CEUS and CECT/CEMRI fusion imaging, the confidence level of the operator for performing RFA improved significantly with regard to visualization of the target lesions (p 5 0.001). The CR rate for RFA was 97.0% (64/66) in accordance to the CECT/CEMRI results 1 month later. No procedure-related deaths and major complications occurred during and after RFA. Conclusion: Fusion of CEUS and CECT/CEMRI improves the visualization of those inconspicuous lesions on conventional ultrasound. It also facilitates improvement in the RFA operators' confidence and CR of RFA. Advances in knowledge: CEUS and CECT/CEMRI fusion imaging is better than both conventional ultrasound and ultrasound-CECT/CEMRI fusion imaging for lesion visualization and improves the operator confidence, thus it should be recommended to be used as a routine in ultrasound-guided percutaneous RFA procedures for liver cancer.

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Section: Discussionmentioning

confidence: 60%

Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

Wang

et al. 2016

BJR

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“…In the case of liver imaging, the scan range should ideally include the main portal vein to allow calculation of time-intensity curves of both the abdominal aorta and the portal vein. Modern CT scanners (.16-detector row scanners with or without volumetric spiral or shuttle scan modes) allow scanning of large volumes of liver tumors or even the entire liver with a dynamic scan range of up to 27 cm, allowing for inclusion of the portal vein in most patients (26,27).…”

Section: Ct Acquisition Protocolmentioning

confidence: 99%

CT Perfusion of the Liver: Principles and Applications in Oncology

Kim¹,

Kamaya²,

Willmann³

2014

Radiology

171

135

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With the introduction of molecularly targeted chemotherapeutics, there is an increasing need for defining new response criteria for therapeutic success because use of morphologic imaging alone may not fully assess tumor response. Computed tomographic (CT) perfusion imaging of the liver provides functional information about the microcirculation of normal parenchyma and focal liver lesions and is a promising technique for assessing the efficacy of various anticancer treatments. CT perfusion also shows promising results for diagnosing primary or metastatic tumors, for predicting early response to anticancer treatments, and for monitoring tumor recurrence after therapy. Many of the limitations of early CT perfusion studies performed in the liver, such as limited coverage, motion artifacts, and high radiation dose of CT, are being addressed by recent technical advances. These include a wide area detector with or without volumetric spiral or shuttle modes, motion correction algorithms, and new CT reconstruction technologies such as iterative algorithms. Although several issues related to perfusion imagingsuch as paucity of large multicenter trials, limited accessibility of perfusion software, and lack of standardization in methods-remain unsolved, CT perfusion has now reached technical maturity, allowing for its use in assessing tumor vascularity in larger-scale prospective clinical trials. In this review, basic principles, current acquisition protocols, and pharmacokinetic models used for CT perfusion imaging of the liver are described. Various oncologic applications of CT perfusion of the liver are discussed and current challenges, as well as possible solutions, for CT perfusion are presented.q RSNA, 2014

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“…Recently available newer multidetector row CT systems or techniques such as 320 detector or volume shuttle scan can offer greater craniocaudal coverage and may be able to overcome this limitation. 22,23 Finally, we did not evaluate hepatic tumors. However, because most overt hepatic tumors are supplied by the hepatic artery only, we believe overt hepatic tumors should be analyzed separately from normal hepatic parenchyma using single-input models.…”

Section: Discussionmentioning

confidence: 99%

Hepatic computed tomography perfusion: comparison of maximum slope and dual-input single-compartment methods

et al. 2010

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Purpose. The aim of the study was to compare two analytical methods-maximum slope (MS) and the dualinput single-compartment model (CM)-in computed tomography (CT) measurements of hepatic perfusion and to assess the effects of extrahepatic systemic factors. Materials and methods. A total of 109 patients underwent hepatic CT perfusion. The scans were conducted at the hepatic hilum 7-77 s after administration of contrast material. Hepatic arterial perfusion (HAP) and portal perfusion (HPP) (ml/min/100 ml) and the arterial perfusion fraction (APF, %) were calculated with the two methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors, including age, sex, risk of cardiovascular disease, compensation for respiratory misregistration, arrival time of contrast material at the abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction. Results. The mean HAPs, HPPs, and APFs were, respectively, 31.4, 104.2, and 23.9 for MS and 27.1, 141.3, and 22.1 for CM. HAP and APF showed signifi cant (P < 0.0001) and moderate correlation (γ = 0.417 and 0.548) and HPP showed poor correlation (γ = 0.172) between the two methods. While MS showed weak correlations (γ = −0.39 to 0.34; P < 0.001 to <0.02) between multiple extrahepatic factors and perfusion values, CM showed weak correlation only between the patients' sex and HAP (γ = 0.31, P = 0.001). Conclusion. Hepatic perfusion values estimated by the two methods are not interchangeable. CM is less susceptible to extrahepatic systemic factors.

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Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases

Cited by 62 publications

References 32 publications

Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

Fusion imaging of contrast-enhanced ultrasound and contrast-enhanced CT or MRI before radiofrequency ablation for liver cancers

CT Perfusion of the Liver: Principles and Applications in Oncology

Hepatic computed tomography perfusion: comparison of maximum slope and dual-input single-compartment methods

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