title: Quantitative assessment of tumour associated neovascularisation in patients with liver cirrhosis and hepatocellular carcinoma: role of dynamic-CT perfusion imaging.
abstract: OBJECTIVE
  To determine the value of perfusion computed tomography (CT-p) in the quantitative assessment of tumour-related neoangiogenesis processes in patients with hepatocellular carcinoma (HCC).
  
  
  METHODS
  Fifty-two biopsy proven HCC lesions were examined with dynamic CT investigations during injection of 50 mL of contrast agent (350 mgI/mL). A dedicated perfusion software which generated a quantitative map of arterial and portal perfusion by means of a colour scale was employed. The following parameters related to the blood microcirculation and tissue perfusion were calculated: hepatic perfusion (Perf), tissue blood volume (BV), hepatic perfusion index (HPI), arterial perfusion (AP), portal perfusion (PP), and time to peak (TTP). Perfusion parameters were statistically analysed, comparing neoplastic lesions with cirrhotic parenchyma.
  
  
  RESULTS
  Perf, BV, HPI and AP values were higher (P < 0.001), whereas PP and TTP were lower (P < 0.001) in HCC relative to the surrounding liver. No significant correlation was found between perfusion parameters and HCC grade. Values of perfusion parameters in the cirrhotic liver of patients with and without HCC were not significantly different.
  
  
  CONCLUSIONS
  Our results suggest that CT-p can help in non-invasive quantification of tumour blood supply, related to the formation of new arterial structures (neoangiogenesis), which are essential for tumour growth.
  
  
  CONCLUSIONS
  Perfusion computed tomography (CT) enables depiction of tumour vascular physiology. Perfusion CT is non-invasive and is now quick to perform and analyse. Quantitative measurements of hepatic perfusion provide important information about hepatocellular carcinoma (HCC). Such perfusion CT data may help in the determination of the outcome of HCC. Perfusion CT can act as an in-vivo biomarker of tumour-related angiogenesis.
authors.affiliation: School of Medicine, University of Milano-Bicocca, Milan, Italy. davide.atena@tiscalinet.it
authors.forename: Davide
authors.initials: D
authors.lastname: Ippolito
authors.forename: Cristina
authors.initials: C
authors.lastname: Capraro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casiraghi
authors.forename: Cristina
authors.initials: C
authors.lastname: Cestari
authors.forename: Sandro
authors.initials: S
authors.lastname: Sironi
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging* / Q000209:etiology; D008113:Liver Neoplasms / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000150:complications / Q000000981:diagnostic imaging*; D055420:Perfusion Imaging / 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*
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