Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results

Abstract

The purpose of this study was to evaluate a whole-organ perfusion protocol of the pancreas in patients with primary pancreas carcinoma and to analyse perfusion differences between normal and diseased pancreatic tissue. Thirty patients with primary pancreatic malignancy were imaged on a 320-slice CT unit. Twenty-nine cancers were histologically proven. CT data acquisition was started manually after contrast-material injection (8 ml/s, 350 mg iodine/ml) and dynamic density measurements in the right ventricle. After image registration, perfusion was determined with the gradient-relationship technique and volume regions-of-interest were defined for perfusion measurements. Contrast time-density curves and perfusion maps were generated. Statistical analysis was performed using the Kolmogorov-Smirnov test for analysis of normal distribution and Kruskal-Wallis test (nonparametric ANOVA) with Bonferroni correction for multiple stacked comparisons. In all 30 patients the entire pancreas was imaged, and registration could be completed in all cases. Perfusion of pancreatic carcinomas was significantly lower than of normal pancreatic tissue (P < 0.001) and could be visualized on colored perfusion maps. The 320-slice CT allows complete dynamic visualization of the pancreas and enables calculation of whole-organ perfusion maps. Perfusion imaging carries the potential to improve detection of pancreatic cancers due to the perfusion differences.

Dual-Energy Perfusion-CT in Recurrent Pancreatic Cancer – Preliminary Results

“…Histopathologically confirmed pancreatic cancer recurrences show similar changes as primary pancreatic tumors with desmoplasticly altered tissue with fibrous stroma and epithelioid tumor cells [26], which explain a reduced blood flow in these lesions. Compared to the reported blood-flow values of pancreatic cancer in previous dual-energy and single-energy studies, the bloodflow values of local recurrence of pancreatic cancer in our study were even lower, with mean values of 17 ± 6 *0.01 min -1 vs. 27 ± 4 *0.01 min -1 and 32 ± 28 *0.01 min -1 [10,11]. This can be explained by the perfusion characteristic of the underlying environmental tissue in which the respective lesions develop.…”

Comparison of Noninvasive Imaging Modalities for Stenosis Grading in Mesenteric Arteries

“…Although we performed an anatomic investigation of the stenosis degree and did not focus on patients with acute mesenteric ischemia, our data providing the best results for CTA support that statement. As noted elsewhere, advanced CT scanners with improved spatial and temporal resolution may visualize the mesenteric vasculature with an image resolution comparable to that of DSA [8, 23,24]. So, CTA seems to have the potential to become the reference imaging modality for mesenteric vasculature [25].…”

Review: The Role of Hyperthermia in Treating Pancreatic Tumors

“…Kandel et al used dynamic volume CT to track the whole organ perfusion of the pancreas in 30 patients. They reported a selective effect in favor of hyperthermia, observing the perfusion in pancreatic carcinomas to be significantly lower than that of normal pancreatic tissue (P<0.001) [15].…”