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Quantification of the Effect of Shuttling on Computed Tomography Perfusion Parameters by Investigation of Aortic Inputs on Different Table Positions From Shuttle-Mode Scans of Lung and Liver Tumors

Ghosh, Payel, PhD*; Chandler, Adam G., PhD; Hobbs, Brian P., PhD; Sun, Jia, PhD; Rong, John, PhD§; Hong, David, MD; Subbiah, Vivek, MD; Janku, Filip, MD, PhD; Naing, Aung, MD; Hwu, Wen-Jen, MD, PhD; Ng, Chaan S., MD, PhD*

Journal of Computer Assisted Tomography: May/June 2018 - Volume 42 - Issue 3 - p 357–364
doi: 10.1097/RCT.0000000000000686
Abdominal Imaging

Objectives The aim of this study was to quantify the effect of shuttling on computed tomography perfusion (CTp) parameters derived from shuttle-mode body CT images using aortic inputs from different table positions.

Methods Axial shuttle-mode CT scans were acquired from 6 patients (10 phases, 2 nonoverlapping table positions 1.4 seconds apart) after contrast agent administration. Artifacts resulting from the shuttling motion were corrected with nonrigid registration before computing CTp maps from 4 aortic levels chosen from the most superior and inferior slices of each table position scan. The effect of shuttling on CTp parameters was estimated by mean differences in mappings obtained from aortic inputs in different table positions. Shuttling effect was also quantified using 95% limits of agreement of CTp parameter differences within-table and between-table aortic positions from the interaortic mean CTp values.

Results Blood flow, permeability surface, and hepatic arterial fraction differences were insignificant (P > 0.05) for both within-table and between-table comparisons. The 95% limits of agreement for within-table blood volume (BV) value deviations obtained from lung tumor regions were less than 4.7% (P = 0.18) compared with less than 12.2% (P = 0.003) for between-table BV value deviations. The 95% limits of agreement of within-table deviations for liver tumor regions were less than 1.9% (P = 0.55) for BV and less than 3.2% (P = 0.23) for mean transit time, whereas between-table BV and mean transit time deviations were less than 11.7% (P < 0.01) and less than 14.6% (P < 0.01), respectively. Values for normal liver tissue regions were concordant.

Conclusions Computed tomography perfusion parameters acquired from aortic levels within-table positions generally yielded higher agreement than mappings obtained from aortic levels between-table positions indicating differences due to shuttling effect.

From the *Department of Diagnostic Radiology, UT MD Anderson Cancer Center, Houston, TX;

GE Healthcare MICT Research, Waukesha, WI; and

Departments of Biostatistics,

§Imaging Physics,

Invest. Cancer Therapeutics, and

Melanoma Medical Oncology, UT MD Anderson Cancer Center, Houston, TX.

Received for publication June 23, 2017; accepted August 28, 2017.

Correspondence to: Payel Ghosh, PhD, Department of Diagnostic Radiology, UT MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX-77030 (e-mail:

This research was funded in part by GE Healthcare, the Cancer Center Support grant, National Institute for health / National Cancer Institute grant P30CA016672 and the John S. Dunn, Sr. Distinguished Chair in Diagnostic Imaging.

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