Objective: The purpose of this study was to determine
how the slice thickness reconstruction influences quantitative perfusion CT
parameters. Materials and Methods: Eighteen patients with cancer (15 non-small-cell
lung cancer, 2 rectal cancer and 1 renal cancer) were examined prospectively
with multidetector row CT. A 90-second perfusion study was performed after
intravenous bolus injection of contrast material. Blood flow, blood volume,
mean transit time and permeability-surface area product were determined at
three different slice thickness reconstruction (1.25, 2.5 and 5 mms) both in
tumors and in paraspinal muscle. Mean values, limits of agreement between
measurements and within-subject coefficient of correlation were obtained for
these thicknesses. Results: Mean ± standard deviation BF, BV, MTT and PS in
lesions were 118.7 ± 117.9 mL/min/100g tissue, 8.2 ± 8.2 mL/100g tissue, 7.5 ±
5.4 seconds and 10.3 ± 7.2 mL/min/100g tissue respectively at1.25 mmslice thickness;
116.1 ± 115.7 mL/min/100g tissue, 7.8 ± 8.7 mL/100g tissue, 7 ± 4.5 seconds and
10.4 ± 7.5 mL/min/100g tissue at 2.5 mms; and 119.6 ± 115.7 mL/min/100g tissue,
7.8 ± 8.8 mL/100g tissue, 5.4 ± 3.4 seconds and 9.6 ± 7.5 mL/min/100g tissue at
5 mms. Differences between means for different slice thickness where relatively
small in all parameters (<15%) except in MTT where difference was up to 37%.
95% limits of agreement were worse when comparing more different slice
thicknesses (e.g. 1.25 vs 5 mms) than when comparing more close slice
thicknesses (1.25 vs 2.5 mms or 2.5 vs 5 mms). Conclusions: There is a
significant variability in perfusion parameter measurements at different slice
thickness reconstruction, particularly in MTT. The more close together the
slice thicknesses were, the smaller was the variability.
References
[1]
Kambadakone, A.R. and Sahani, D.V. (2009) Body Perfusion CT: Technique, Clinical Applications, and Advances. Radiologic Clinics of North America, 47, 161-178. http://dx.doi.org/10.1016/j.rcl.2008.11.003
[2]
Axel, L. (1980) Cerebral Blood Flow Determination by Rapid-Sequence Computed Tomography: Theoretical Analysis. Radiology, 137, 679-686.
[3]
García-Figueiras, R., Goh, V.J., Padhani, A.R., Baleato-Gonzalez, S., Garrido, M., León, L. and Gómez-Caamano, A. (2013) CT Perfusion in Oncologic Imaging: A Useful Tool? AJR, 1, 8-19. http://dx.doi.org/10.2214/AJR.11.8476
[4]
Ng, Q.S. and Goh, V. (2010) Angiogenesis in Non-Small Cell Lung Cancer: Imaging with Perfusion Computed Tomography. Journal of Thoracic Imaging, 25, 142-150. http://dx.doi.org/10.1097/RTI.0b013e3181d29ccf
[5]
Petralia, G., Bonello, L., Viotti, S., Preda, L., d’Andrea G. and Bellomi, M. (2010) CT Perfusion in Oncology: How to Do It. Cancer Imaging, 10, 8-19. http://dx.doi.org/10.1102/1470-7330.2010.0001
[6]
Bland, J.M. and Altman, D.G. (1986) Statistical Methods for Assessing Agreement between Two Methods of Clinical Measurement. Lancet, 1, 307-310. http://dx.doi.org/10.1016/S0140-6736(86)90837-8
[7]
Quan, H. and Shih, W.J. (1996) Assessing Reproducibility by the Within-Subject Coefficient of Variation with Random Effects Models. Biometrics, 52, 1195-1203. http://dx.doi.org/10.2307/2532835
[8]
R Core Team (2013) R: A Language and Environment for Statistical Computing. http://www.R-project.org/
[9]
Carstensen, B., Gurrin, L. and Ekstrom, C. (2012) MethComp: Functions for Analysis of Method Comparison Studies. http://bendixcarstensen.com/MethComp/
[10]
Pinheiro, J., Bates, D., DebRoy, S., Sarkar, D. and the R Development Core Team (2013) nlme: Linear and Nonlinear Mixed Effects Models. R package version 3.1-109.
[11]
Goh, V., Dattani, M., Farwell, J., Shekhdar, J., Tam, E., Patel, S., Juttla, J., Simcock, I., Stirling, J., Mandeville, H., Aird, E. and Hoskin, P. (2011) Radiation Dose from Volumetric Helical Perfusion CT of the Thorax, Abdomen or Pelvis. European Radiology, 21, 974-981. http://dx.doi.org/10.1007/s00330-010-1997-y
[12]
Goh, V., Halligan, S., Hugill, J.-A. and Bartram, C.I. (2006) Quantitative Assessment of Tissue Perfusion Using MDCT Comparison of Colorectal Cancer and Skeletal Muscle Measurement Reproducibility. AJR, 187, pp.164-169. http://dx.doi.org/10.2214/AJR.05.0050
[13]
Ng, C.S., Chandler, A.G., Wei, W., Herron, D.H., Anderson, E.F., Kurzrock, R. and Charnsangavej, C. (2011) Reproducibility of CT Perfusion Parameters in Liver Tumors and Normal Liver. Radiology, 260, 762-770. http://dx.doi.org/10.1148/radiol.11110331
[14]
Goh, V., Halligan, S. and Bartram, C.I. (2007) Quantitative Tumor Perfusion Assessment with Multidetector CT: Are Measurements from Two Commercial Software Packages Interchangeable? Radiology, 242, 777-782. http://dx.doi.org/10.1148/radiol.2423060279