title: Standardized perfusion value of the esophageal carcinoma and its correlation with quantitative CT perfusion parameter values.
abstract: OBJECTIVE
  Standardized perfusion value (SPV) is a universal indicator of tissue perfusion, normalized to the whole-body perfusion, which was proposed to simplify, unify and allow the interchangeability among the perfusion measurements and comparison between the tumor perfusion and metabolism. The aims of our study were to assess the standardized perfusion value (SPV) of the esophageal carcinoma, and its correlation with quantitative CT perfusion measurements: blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) of the same tumor volume samples, which were obtained by deconvolution-based CT perfusion analysis.
  
  
  METHODS
  Forty CT perfusion studies of the esophageal cancer were analyzed, using the commercial deconvolution-based CT perfusion software (Perfusion 3.0, GE Healthcare). The SPV of the esophageal tumor and neighboring skeletal muscle were correlated with the corresponding mean tumor and muscle quantitative CT perfusion parameter values, using Spearman's rank correlation coefficient (rS).
  
  
  RESULTS
  Median SPV of the esophageal carcinoma (7.1; range: 2.8-13.4) significantly differed from the SPV of the skeletal muscle (median: 1.0; range: 0.4-2.4), (Z=-5.511, p<0.001). The cut-off value of the SPV of 2.5 enabled discrimination of esophageal cancer from the skeletal muscle with sensitivity and specificity of 100%. SPV of the esophageal carcinoma significantly correlated with corresponding tumor BF (rS=0.484, p=0.002), BV (rS=0.637, p<0.001) and PS (rS=0.432, p=0.005), and SPV of the skeletal muscle significantly correlated with corresponding muscle BF (rS=0.573, p<0.001), BV (rS=0.849, p<0.001) and PS (rS=0.761, p<0.001).
  
  
  CONCLUSIONS
  We presented a database of the SPV for the esophageal cancer and proved that SPV of the esophageal neoplasm significantly differs from the SPV of the skeletal muscle, which represented a sample of healthy tissue. The SPV was validated against quantitative CT perfusion measurements and statistically significant correlation was proved.
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: avstefan@eunet.rs.
authors.forename: A
authors.initials: A
authors.lastname: Djuric-Stefanovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: crvzve4@gmail.com.
authors.forename: Dj
authors.initials: D
authors.lastname: Saranovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: dsobic2@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Sobic-Saranovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Unit of Digestive Radiology (First University Surgical Clinic), Center of Radiology and MR, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: draganmasulovic@yahoo.com.
authors.forename: D
authors.initials: D
authors.lastname: Masulovic
authors.affiliation: Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Center of Nuclear Medicine, Clinical Center of Serbia, Belgrade, Serbia. Electronic address: veraart@beotel.rs.
authors.forename: V
authors.initials: V
authors.lastname: Artiko
mesh_terms: D001810:Blood Volume; D004938:Esophageal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D010477:Perfusion; D055420:Perfusion Imaging / Q000379:methods; D011446:Prospective Studies; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
keywords: CT perfusion; Deconvolution; Esophageal carcinoma; Standardized perfusion value