Whole-organ perfusion of the pancreas using dynamic volume CT in patients with primary pancreas carcinoma: acquisition technique, post-processing and initial results |
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Authors: | Sonja Kandel Christian Kloeters Henning Meyer Patrick Hein Andreas Hilbig Patrik Rogalla |
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Institution: | 1. Department of Radiology, Campus Charité Mitte, Charité – Universit?tsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany 2. Medical Clinic III - Hematology and Oncology, Campus Virchow Klinikum, Charité - University Medicine, Berlin, Germany
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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. |
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