title: Early modifications of hepatic perfusion measured by functional CT in a rat model of hepatocellular carcinoma using a blood pool contrast agent.
abstract: Macromolecular contrast-enhanced functional CT was performed to characterize early perfusion changes in hepatocellular carcinoma (HCC). Fourteen rats with chemically induced primary liver tumors ranging pathologically from hyperplasia to HCC and 15 control rats were investigated. Two dynamic CT scans using an experimental macromolecular contrast agent were performed on a single slice 11 and 18 weeks after tumor induction followed by pathological examination. A deconvolution mathematical model was applied, yielding the hepatic perfusion index (HPI), mean transit time (MTT), liver distribution volume (LDV) and arterial, portal and total blood flows (FA, FP, FT). Analysis was performed on one slice per rat, containing overall two hyperplasia, six dysplasia and 15 HCC. On the first scans, HCC at an early pathological stage had a low FP (-30%, P=0.002) but a normal arterial-portal balance. On the scan contemporary to pathology, HCC perfusion parameters showed an inversion of the arterial-portal balance (HPI +212%, P<0.0001), with a high FA (+56%, P=0.002) and a low FP (-69%, P<0.0001). Sensitivity and specificity of detection of HCC by perfusion CT were high (87 and 80%) on late scans; but also on the earlier scans (86 and 65%), even though only one (7%) was visible to the eye. Perfusion-CT allowed early detection of HCC. This technique could contribute in the detection and characterization of liver lesions in clinical studies.
authors.affiliation: Laboratoire de Recherche en Imagerie, INSERM U494, Necker Institute, 156 rue de Vaugirard, 75015 Paris, France. lfd@free.fr
authors.forename: Laure S
authors.initials: LS
authors.lastname: Fournier
authors.forename: Charles Andre
authors.initials: CA
authors.lastname: Cuenod
authors.forename: Cedric
authors.initials: C
authors.lastname: de Bazelaire
authors.forename: Nathalie
authors.initials: N
authors.lastname: Siauve
authors.forename: Christophe
authors.initials: C
authors.lastname: Rosty
authors.forename: Phuong Lan
authors.initials: PL
authors.lastname: Tran
authors.forename: Guy
authors.initials: G
authors.lastname: Frija
authors.forename: Olivier
authors.initials: O
authors.lastname: Clement
mesh_terms: D000818:Animals; D001783:Blood Flow Velocity / Q000502:physiology; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000139:chemically induced / Q000000981:diagnostic imaging*; D003287:Contrast Media / Q000008:administration & dosage*; D004195:Disease Models, Animal; D007091:Image Processing, Computer-Assisted / Q000379:methods; D017613:Iodine Compounds; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000473:pathology; D008102:Liver Circulation; D008114:Liver Neoplasms, Experimental / Q000098:blood supply / Q000139:chemically induced / Q000000981:diagnostic imaging*; D008297:Male; D009930:Organic Chemicals; D051381:Rats; D017208:Rats, Wistar; D012680:Sensitivity and Specificity; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D003287:Contrast Media; D017613:Iodine Compounds; D009930:Organic Chemicals; C427128:P743