Quantitative CT liver perfusion imaging

Clinical Case

Patient History

A man in his 70s was referred to CT for cholangiocarcinoma follow-up.
Whole-organ dynamic acquisition was performed to assess morphological and functional changes of the hepatic lesion.

Acquisition

  • Dynamic acquisition

  • 160 mm axial for whole organ coverage 

  • 60 cc of contrast media (350 mg I/mL)

  • BMI: 24

  • ASiR-V1 80%

  • DLP 880 mGy-cm

  • 13 mSv2

  • Group 1: wash-in (17 passes)

    • 100 kV & 90 mA

    • 0.5 sec rotation speed

    • 2 sec between passes

    Group 2: wash-out (8 passes)

    • 100 kV & 90 mA

    • 0.5 sec rotation speed

    • 8.5 sec between passes

Results

Analysis of the perfusion maps demonstrates a reduction of blood volume, an increase of MTT and blood flow compared to normal liver parenchyma. The high HAF shows that blood in the lesion is mainly supplied by the hepaticartery. 


Conclusion

Revolution CT enables accurate liver dynamic perfusion thanks to whole organ coverage, HU uniformity, and adequate temporal resolution thanks to no table motion.

The use of a variable sampling rate in combination with ASiR-V and flexible tube current allows performing this comprehensive study at low dose, making it suitable for routine applications. 


Testimonial

« Revolution CT allows acquiring anatomical and functional information in one examination, at low dose. This capability has the potential to reduce the need for additional investigations. In cardiac, this will help us evaluate the impact of a stenosis on the myocardial perfusion and therefore improve the specificity of Cardiac CT. In oncology, perfusion imaging has the potential to help characterize lesion, and to better evaluate the response under specific treatments, such as anti-angiogenics. In early stroke management, identifying penumbra and necrosis can be critical for treatment decision and patient management.”

Jean-Louis Sablayrolles


Enabling Technologies

  • The Revolution CT allows for whole organ dynamic acquisition with up to 160 mm of coverage, with no table motion. This enables perfusion study of the heart, brain, liver, kidneys and other organ and tissues. It also provides you with 4D imaging capabilities for all anatomies to visualize vascular flow, organ motion or kinetic properties.

  • Revolution CT introduces the groundbreaking Gemstone* Clarity Detector, with focally-aligned, miniaturized modules and 3D collimator that is designed to ensure contrast uniformity and excellent image quality across the whole detector and overcome challenges such as cone beam or beam hardening artifacts associated with wide coverage.

  • The next generation of iterative reconstruction, ASiR-V, the flexible collimation (between 5 mm to 160 mm), the variable sampling rate and tube current during dynamic perfusion acquisition help you to optimize radiation dose of such studies. 


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