Assessment of the spatial pattern of colorectal tumour perfusion estimated at perfusion CT using two-dimensional fractal analysis |
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Authors: | Vicky Goh Bal Sanghera David M Wellsted Josefin Sundin Steve Halligan |
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Institution: | (1) Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex, HA6 2RN, UK;(2) Research and Development Support Unit, University of Hertfordshire, Hatfield, UK;(3) Department of Academic Radiology, University College Hospital, London, UK |
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Abstract: | The aim was to evaluate the feasibility of fractal analysis for assessing the spatial pattern of colorectal tumour perfusion
at dynamic contrast-enhanced CT (perfusion CT). Twenty patients with colorectal adenocarcinoma underwent a 65-s perfusion
CT study from which a perfusion parametric map was generated using validated commercial software. The tumour was identified
by an experienced radiologist, segmented via thresholding and fractal analysis applied using in-house software: fractal dimension,
abundance and lacunarity were assessed for the entire outlined tumour and for selected representative areas within the tumour
of low and high perfusion. Comparison was made with ten patients with normal colons, processed in a similar manner, using
two-way mixed analysis of variance with statistical significance at the 5% level. Fractal values were higher in cancer than
normal colon (p ≤ 0.001): mean (SD) 1.71 (0.07) versus 1.61 (0.07) for fractal dimension and 7.82 (0.62) and 6.89 (0.47) for
fractal abundance. Fractal values were lower in ‘high’ than ‘low’ perfusion areas. Lacunarity curves were shifted to the right
for cancer compared with normal colon. In conclusion, colorectal cancer mapped by perfusion CT demonstrates fractal properties.
Fractal analysis is feasible, potentially providing a quantitative measure of the spatial pattern of tumour perfusion. |
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Keywords: | Fractal analysis Colorectal cancer Dynamic contrast-enhanced CT Perfusion CT |
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