title: Foot CT perfusion in patients with peripheral arterial occlusive disease (PAOD): a feasibility study.
abstract: OBJECTIVE
  To prospectively assess the technical feasibility and reproducibility of quantitative foot perfusion multidetector-row computed tomography (MDCT) in patients with peripheral occlusive artery disease (PAOD) and to evaluate perfusion parameters changes after endovascular treatment.
  
  
  METHODS
  Institutional review board approval and informed patient consent were obtained. 10 patients older than 65 years (mean 74.1 years, range 66-95 years) with PAOD and who were referred to our department for single-limb endovascular treatment were enrolled prospectively. All patients underwent foot CT perfusion examinations before and within 72 h after endovascular treatment. A 64-row CT lightspeed VCT scanner (GE Medical Systems) was used with acquisition of eight contiguous 5-mm reconstructed sections (60-s acquisition time; 40 mL Iomeprol 400 mgI/mL, @4 mL/s). Data were analyzed by two blinded readers using commercially available software to calculate perfusion parameters. Inter-observer and intra-observer agreement of perfusion CT analysis was assessed using Bland-Altman analyses and intra-class correlation coefficient (ICC). Changes in perfusion parameters after endovascular treatment were assessed using Wilcoxon's test.
  
  
  RESULTS
  Good inter-observer and intra-observer agreement was obtained in all patients. Good agreement was obtained for perfusion parameters for the untreated foot and in repeated studies. By comparing perfusion parameters in the treated foot, a significantly shorter mean transit time (MTT) was obtained.
  
  
  CONCLUSIONS
  Foot CT perfusion is a feasible and reproducible technique. A significant decrease of MTT between pre- and post-revascularization suggests improved flow in the below-the-knee arteries.
authors.affiliation: Department of Bioimaging and Radiological Sciences, Institute of Radiology, "A. Gemelli" Hospital - Catholic University, L.go A Gemelli 8, 00168 Rome, Italy. roberto.iezzi@rm.unicatt.it
authors.forename: R
authors.initials: R
authors.lastname: Iezzi
authors.forename: M
authors.initials: M
authors.lastname: Santoro
authors.forename: R
authors.initials: R
authors.lastname: Dattesi
authors.forename: M F
authors.initials: MF
authors.lastname: La Torre
authors.forename: G
authors.initials: G
authors.lastname: Tinelli
authors.forename: F
authors.initials: F
authors.lastname: Snider
authors.forename: L
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging* / Q000601:surgery*; D057510:Endovascular Procedures; D005240:Feasibility Studies; D005260:Female; D005528:Foot / Q000098:blood supply* / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D055420:Perfusion Imaging / Q000379:methods*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome
keywords: Endovascular treatment; Foot CT perfusion; Perfusion parameters; Peripheral Arterial occlusive disease (PAOD)