title: Abnormal hepatic perfusion index predicts recurrence of colorectal carcinoma.
abstract: OBJECTIVE
  The hepatic perfusion index (HPI) is a ratio of the gradient of hepatic arterial to total hepatic blood flow. This study correlated HPI with histopathological indicators of prognosis and disease-free survival following curative resection of colorectal cancer.
  
  
  METHODS
  HPI was measured preoperatively by dynamic hepatic scintigraphy in 37 patients with a primary colorectal cancer and no evidence of distant metastases who underwent a curative resection.
  
  
  RESULTS
  Abnormally elevated HPI were detected in 49% of patients and were significantly more frequent in association with locally advanced tumours (T3 and T4) in comparison with early tumours (T1 and T2; 59% vs 20%, respectively; P=0.04). There was no association between abnormal HPI and presence of lymph node metastases or degree of tumour differentiation. The 18-month disease-free survival rate of patients with abnormal HPI was significantly shorter than that of patients with normal HPI (53% vs 100%, respectively; P=0.01), and this was independent of the T category.
  
  
  CONCLUSIONS
  HPI predicts the risk of recurrent colorectal carcinoma, and this measurement should be included in the panel of prognostic markers in future clinical trials.
authors.affiliation: Professorial Surgical Unit, St James's University Hospital, Leeds, UK Department of Medical Physics, St James's University Hospital, Leeds, UK.
authors.forename: A I
authors.initials: AI
authors.lastname: Sarela
authors.forename: H J
authors.initials: HJ
authors.lastname: Gallagher
authors.forename: R C
authors.initials: RC
authors.lastname: Macadam
authors.forename: D S
authors.initials: DS
authors.lastname: O'Riordain
authors.forename: A
authors.initials: A
authors.lastname: Parkin
authors.forename: P J
authors.initials: PJ
authors.lastname: Guillou