title: Role of Perfusion CT Differentiating Hemangiomas from Malignant Hepatic Lesions.
abstract: OBJECTIVE
  The purpose of the study was to determine the role of computed tomography (CT) perfusion in differentiating hemangiomas from malignant hepatic lesions.
  
  
  METHODS
  This study was approved by the institutional review board. All the patients provided informed consent. CT perfusion was performed with 64 multidetector CT (MDCT) scanner on 45 patients including 27 cases of metastasis, 9 cases of hepatocellular carcinoma (HCC), and 9 cases of hemangiomas. A 14 cm span of the liver was covered during the perfusion study. Data was analyzed to calculate blood flow (BF), blood volume (BV), permeability surface area product (PS), mean transit time (MTT), hepatic arterial fraction (HAF), and induced residue fraction time of onset (IRFTO). CT perfusion parameters at the periphery of lesions and background liver parenchyma were compared.
  
  
  RESULTS
  Significant changes were observed in the perfusion parameters at the periphery of different lesions. Of all the perfusion parameters BF, HAF, and IRFTO showed most significant changes. In our study we found: BF of more than 400 ml/100 g/min at the periphery of the hemangiomas showed sensitivity of 88.9%, specificity of 83.3%, positive predictive value (PPV) of 57.1%, and negative predictive value (NPV) of 96.7% in differentiating hemangiomas from hepatic malignancy; HAF of more than 60% at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3% and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy; IRFTO of more than 3 s at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3%, and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy.
  
  
  CONCLUSIONS
  Perfusion CT is a helpful tool in differentiating hemangiomas from hepatic malignancy by its ability to determine changes in perfusion parameters of the lesions.
authors.affiliation: Department of Radiodiagnosis and Intervention Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Jagjeet
authors.initials: J
authors.lastname: Singh
authors.affiliation: Department of Radiodiagnosis and Intervention Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Sanjiv
authors.initials: S
authors.lastname: Sharma
authors.affiliation: Department of Radiodiagnosis and Intervention Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Neeti
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Department of Radiodiagnosis and Intervention Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: R G
authors.initials: RG
authors.lastname: Sood
authors.affiliation: Department of Radiodiagnosis and Intervention Radiology, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Sood
authors.affiliation: Department of Imaging Sciences, University of Rochester Medical Center, New York, USA.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Sidhu
keywords: Hemangioma; hepatocellular carcinoma; liver; metastasis; perfusion
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