title: Total-liver-volume perfusion CT using 3-D image fusion to improve detection and characterization of liver metastases.
abstract: The purpose of this study was to evaluate the feasibility of a total-liver-volume perfusion CT (CTP) technique for the detection and characterization of liver metastases. Twenty patients underwent helical CT of the total liver volume before and 11 times after intravenous contrast-material injection. To decrease distortion artifacts, all phases were co-registered using 3-D image fusion before creating blood-flow maps. Lesion-based sensitivity and specificity for liver metastases of first the conventional four phases (unenhanced, arterial, portal venous, and equilibrium) and later all 12 phases including blood-flow maps were determined as compared to intraoperative ultrasound and surgical exploration. Arterial and portal venous perfusion was calculated for normal-appearing and metastatic liver tissue. Total-liver-volume perfusion values were comparable to studies using single-level CTP. Compared to four-phase CT, total -liver-volume CTP increased sensitivity to 89.2 from 78.4% (P=0.046) and specificity to 82.6 from 78.3% (P=0.074). Total -liver-volume CTP is a noninvasive, quantitative, and feasible technique. Preliminary results suggest an improved detection of liver metastases for CTP compared to four-phase CT.
authors.affiliation: Department of Radiology, Vrije Universiteit Medical Center, De Boelelaan 1117, 1081HV Amsterdam, The Netherlands. mr.meijerink@vumc.nl
authors.forename: Martijn R
authors.initials: MR
authors.lastname: Meijerink
authors.forename: Jan Hein T M
authors.initials: JH
authors.lastname: van Waesberghe
authors.forename: Lineke
authors.initials: L
authors.lastname: van der Weide
authors.forename: Petrousjka
authors.initials: P
authors.lastname: van den Tol
authors.forename: Sybren
authors.initials: S
authors.lastname: Meijer
authors.forename: Cornelis
authors.initials: C
authors.lastname: van Kuijk
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*