title: Assessment of tumor vascularization in pancreatic adenocarcinoma using 128-slice perfusion computed tomography imaging.
abstract: OBJECTIVE
  Computed tomography (CT) perfusion studies can provide valuable information regarding tumor vascularization. We report on a study assessing CT perfusion characteristics in the normal pancreas and in patients with pancreatic adenocarcinoma.
  
  
  METHODS
  Twenty healthy subjects and 20 patients with histologically confirmed pancreatic adenocarcinoma were included in the study after written informed consent and approval by our institutional review board. All subjects underwent perfusion CT imaging of the pancreas using 128-slice dual-source CT. The scanning sequence included 18 scans. Parametric maps of blood volume (BV), blood flow (BF), and permeability surface area product (PS) were generated and compared with density measurements.
  
  
  RESULTS
  In normal pancreas, no significant difference in perfusion values was observed between head, body, and tail of the pancreas. Mean organ values were 76.76 (SD, 15.6) mL/100 g/min, 15.80 (SD, 2.40) mL/100 g, and 27.74 (SD, 16.8) mL/100 g/min for BF, BV, and PS, respectively. Compared with the normal pancreas, a 60% reduction in BF and BV was observed in the tumor tissue. Perfusion values gradually increased toward the tumor rim. Necrotic tumor areas were identified in 25% of patients. No significant differences were observed when comparing normal pancreas and healthy pancreatic tissue in adenocarcinoma patients.
  
  
  CONCLUSIONS
  The feasibility of whole-tumor perfusion imaging using 128-slice CT was demonstrated in patients with pancreatic adenocarcinoma. Perfusion CT provides additional information compared with image assessment based on density measurements (Hounsfield units) and allows noninvasive assessment of vascularization in the tumor tissue.
authors.affiliation: Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent, Belgium. Louke.Delrue@UZGent.be
authors.forename: Louke
authors.initials: L
authors.lastname: Delrue
authors.forename: Peter
authors.initials: P
authors.lastname: Blanckaert
authors.forename: Dokus
authors.initials: D
authors.lastname: Mertens
authors.forename: Ercan
authors.initials: E
authors.lastname: Cesmeli
authors.forename: Wim P
authors.initials: WP
authors.lastname: Ceelen
authors.forename: Philippe
authors.initials: P
authors.lastname: Duyck
mesh_terms: D000230:Adenocarcinoma / Q000098:blood supply* / Q000000981:diagnostic imaging*; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D001810:Blood Volume; D016022:Case-Control Studies; D003287:Contrast Media; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000098:blood supply; D010190:Pancreatic Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging*; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014283:Triiodobenzoic Acids
chemical_list: D003287:Contrast Media; D014283:Triiodobenzoic Acids; C044834:iodixanol