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Assessment of Tumor Vascularization in Pancreatic Adenocarcinoma Using 128-Slice Perfusion Computed Tomography Imaging

Delrue, Louke MD; Blanckaert, Peter PhD; Mertens, Dokus; Cesmeli, Ercan MD; Ceelen, Wim P. MD, PhD; Duyck, Philippe MD, PhD

Journal of Computer Assisted Tomography: July/August 2011 - Volume 35 - Issue 4 - pp 434-438
doi: 10.1097/RCT.0b013e318223f0c5
Abdominal Imaging

Objective: Computed tomography (CT) perfusion studies can provide valuable information regarding tumor vascularization. We report on a study assessing CT perfusion characteristics in the normal pancreas and in patients with pancreatic adenocarcinoma.

Methods: Twenty healthy subjects and 20 patients with histologically confirmed pancreatic adenocarcinoma were included in the study after written informed consent and approval by our institutional review board. All subjects underwent perfusion CT imaging of the pancreas using 128-slice dual-source CT. The scanning sequence included 18 scans. Parametric maps of blood volume (BV), blood flow (BF), and permeability surface area product (PS) were generated and compared with density measurements.

Results: In normal pancreas, no significant difference in perfusion values was observed between head, body, and tail of the pancreas. Mean organ values were 76.76 (SD, 15.6) mL/100 g/min, 15.80 (SD, 2.40) mL/100 g, and 27.74 (SD, 16.8) mL/100 g/min for BF, BV, and PS, respectively. Compared with the normal pancreas, a 60% reduction in BF and BV was observed in the tumor tissue. Perfusion values gradually increased toward the tumor rim. Necrotic tumor areas were identified in 25% of patients. No significant differences were observed when comparing normal pancreas and healthy pancreatic tissue in adenocarcinoma patients.

Conclusions: The feasibility of whole-tumor perfusion imaging using 128-slice CT was demonstrated in patients with pancreatic adenocarcinoma. Perfusion CT provides additional information compared with image assessment based on density measurements (Hounsfield units) and allows noninvasive assessment of vascularization in the tumor tissue.

From the *Department of Radiology and Medical Imaging, Ghent University Hospital, Ghent; †Siemens Healthcare NV/SA, Brussels; Departments of ‡Gastro-Enterology, and §Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.

Received for publication March 29, 2011; accepted May 11, 2011.

Reprints: Louke Delrue, MD, Department of Radiology and Medical Imaging, Ghent University Hospital-4K12-E, De Pintelaan 185, B-9000 Ghent, Belgium (e-mail: Louke.Delrue@UZGent.be).

One coauthor (D.M.) is employed by Siemens Healthcare, Belgium, and provided scientific support in the study. For the remaining authors, no conflicts of interest are declared.

Copyright © 2011 Wolters Kluwer Health, Inc. All rights reserved.