title: Perfusion computed tomographic assessment of early hepatocellular carcinoma in cirrhotic liver disease: initial observations.
abstract: OBJECTIVE
  To prospectively assess perfusion computed tomography (CT) for evaluation of tumor vascularity of early hepatocellular carcinoma (HCC) in patients with cirrhosis.
  
  
  METHODS
  The study cohort included 30 patients who had Child-Pugh class A or B liver cirrhosis and a single histopathologically confirmed HCC not exceeding 3 cm in diameter. All patients underwent perfusion CT study using a multidetector 16-slice CT. Four perfusion parameters were measured for the HCCs and cirrhotic liver parenchyma: hepatic perfusion (HP), blood volume (BV), arterial perfusion (AP), and time to peak (TTP). Perfusion parameters were described with quartile (qt) values of their distribution; univariate paired Wilcoxon signed rank test was used for statistical analysis.
  
  
  RESULTS
  The values of perfusion parameters measured within tumor tissue were the following: HP (milliliters per 100 g per minute): median = 45.7 (first qt = 35.3; third qt = 61.3); BV (milliliters per 100 mg): median = 20.6 (first qt = 13.0; third qt = 27.6); AP (milliliters per minute): median = 44.2 (first qt = 36.7; third qt = 57.0); TTP (seconds): median = 18.7 (first q = 15.9; third qt = 24.0). Our data showed that HP, BV, and AP values were higher (P < 0.001), whereas TTP was lower (P < 0.001), in HCCs relative to the cirrhotic liver parenchyma. For all the CT perfusion parameters calculated, there was a significant difference between HCC and background cirrhotic liver.
  
  
  CONCLUSIONS
  Preliminary results suggest that in patients with cirrhosis and early HCC, perfusion CT is a feasible technique for noninvasive assessment of tumor vascularity.
authors.affiliation: Department of Diagnostic Radiology, School of Medicine, University of Milano-Bicocca, Milan, Italy. davide.atena@tiscalinet.it
authors.forename: Davide
authors.initials: D
authors.lastname: Ippolito
authors.forename: Sandro
authors.initials: S
authors.lastname: Sironi
authors.forename: Massimo
authors.initials: M
authors.lastname: Pozzi
authors.forename: Laura
authors.initials: L
authors.lastname: Antolini
authors.forename: Laura
authors.initials: L
authors.lastname: Ratti
authors.forename: Franca
authors.initials: F
authors.lastname: Meloni
authors.forename: Francesca
authors.initials: F
authors.lastname: Invernizzi
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Valsecchi
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Fazio
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D010865:Pilot Projects; D011230:Precancerous Conditions / Q000000981:diagnostic imaging*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*