Feasibility of wide detector CT perfusion imaging performed during routine staging and restaging of pancreatic ductal ad
- PDF / 1,585,540 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 115 Downloads / 175 Views
PANCREAS
Feasibility of wide detector CT perfusion imaging performed during routine staging and restaging of pancreatic ductal adenocarcinoma Ryan B. O’Malley1 · Erik V. Soloff1 · Andrew L. Coveler2 · Danielle H. Cox1 · Nitin Desai1 · Janet M. Busey1 · Greta M. Valentin3 · Carolyn L. Wang1 Received: 6 July 2020 / Revised: 15 September 2020 / Accepted: 24 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To evaluate the feasibility of CT perfusion performed during routine multiphase contrast-enhanced CT on a 160 mm wide-coverage 256-slice scanner in patients with pancreatic ductal adenocarcinoma (PDAC). Methods Fifty-seven patients had a CT perfusion acquisition during their routine multiphase CT. Perfusion was performed 5 to 42.5 s (15 passes at 2.5 s intervals) after intravenous contrast administration (4.2–5 ml/s), followed by pancreatic parenchymal and portal venous phases for clinical interpretation. Perfusion maps were generated and blood flow (BF), blood volume (BV), and permeability surface area product (PS) for tumor and uninvolved pancreas were calculated using deconvolution algorithms and compared to existing similar publications. Radiation dose information was recorded and size-specific dose estimate (SSDE) was calculated using body dimensions. Results Diagnostic quality of standard images was unaffected by performing the perfusion acquisition. Average tumor center BF was 20.8 ± 12.1 ml/100 g/min, BV 2.5 ± 2.1 ml/100 g and PS 15.5 ± 39.4 ml/100 g/min. Average pancreas BF was 90.8 ± 50.2 ml/100 g/min, BV 11.9 ± 4.3 ml/100 g and PS 33.6 ± 27.7 ml/100 g/min. For the perfusion acquisition, mean SSDE was 57 ± 11 mGy, CTDIvol 43 ± 6 mGy and DLP 685 ± 100 mGy-cm. Conclusion Adding a perfusion CT acquisition to standard pancreatic CT protocol is feasible using a wide-detector 256-slice CT scanner and adds quantitative information while maintaining diagnostic quality of the standard of care examination. This novel protocol adds no time or cost to the examination and yields perfusion parameters that are comparable to existing literature using a separate dedicated perfusion protocol. Graphic abstract
Keywords Computed tomography · CT perfusion · Pancreas · Pancreatic ductal adenocarcinoma · Oncology imaging Extended author information available on the last page of the article
13
Vol.:(0123456789)
Introduction Pancreatic ductal adenocarcinoma (PDAC) is the third leading cause of cancer death in the USA, its incidence is increasing by an estimated 0.5% per year, and prognosis is dismal with 5-year survival rate of about 10% [1–3]. The widespread availability and advancement of CT technology has led to earlier diagnosis and better ability to determine resectability. Although this has resulted in more patients presenting with resectable disease, it has not translated into improved 5-year survival [4]. Nonetheless, surgical resection offers the only potential cure [5, 6]. Approximately 30% of patients present with locally advanced (LA) disease, usually d
Data Loading...
