Imaging Pearls ❯ 3D and Workflow ❯ Perfusion
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- CT and Oncology: Whats Next-
- CT Perfusion Imaging
- CT Texture Mapping
- Beyond RECIST
- Advanced 3D Mapping - Tumor Angiogenesis: Imaging
- PET
- MR
- Ultrasound
- CT with perfusion imaging - Clinical Applications of Perfusion in Oncology
- Lesion characterization
- Staging
- Prognostic biomarker and response prediction
- Response assessment - “ Tumor angiogenesis is essential for cancer growth and provides an attractive target for oncologic therapies. CT perfusion is an emerging imaging tool that provides both qualitative and quantitative information regarding tumor angiogenesis.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - “CT perfusion may augment standard therapeutic assessment in clinical trials and in the clinical environment. By use of functional imaging techniques to assess the response to antiangiogenic drugs, it would be possible to achieve earlier discrimination between responders and nonresponders, which would allow a more patient tailored therapeutic approach, avoiding the use of ineffective drugs.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - “ Currently, these modalities have been used for evaluating tumor angiogenesis using two main approaches; imaging of molecular components of angiogenic or tumor associated blood vessels (an emerging application of imaging techniques such as PET) and measurement of regional blood flow (BF), blood volume (BV), and vessel permeability using dynamic contrast enhanced imaging techniques, including CT perfusion.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - “ Tumor angiogenesis is considered an important prognostic factor and a promising target of new antitumor therapies. With an increasing emphasis on imaging evaluation of the tumor microenvironment and further technologic gains, CT perfusion has evolved as a key functional imaging technique in both research and clinical practice in this setting.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - “Perfusion CT measurements may measure vascularity of colorectal tumors, however, correlation with MVD (microvessel density), which is a morphologic measure, appears inappropriate.”
Perfusion CT Vascular Parameters Do Not Correlate with Immunohistochemically Derived Microvessel Density Count in Colorectal Tumors
Dighe S et al.
Radiology 2013; 268:400-410 - “Perfusion CT calculated vascular parameters do not correlate with microvessel density count obtained by means of immunohistochemical staining, which is the measure of angiogenesis in colorectal tumors.”
Perfusion CT Vascular Parameters Do Not Correlate with Immunohistochemically Derived Microvessel Density Count in Colorectal Tumors
Dighe S et al.
Radiology 2013; 268:400-410 - “ Therefore we believe that perfusion CT measurements may still be able to provide a measure of vascularity of the tumor, however, its correlation with MVD appears to be inappropriate. Its role in assessment of the treatment response to antiangiogenic agents needs to be evaluated in further studies.”
Perfusion CT Vascular Parameters Do Not Correlate with Immunohistochemically Derived Microvessel Density Count in Colorectal Tumors
Dighe S et al.
Radiology 2013; 268:400-410 - Purpose: To compare four different tracer kinetic models for the analysis of dynamic contrast material enhanced computed tomographic (CT) data with respect to the prediction of 5-year overall survival in primary colorectal cancer
Conclusion: Parameter values differ significantly between models. Of the models investigated, the distributed parameter model was the best predictor of 5 year overall survival
Primary Colorectal Cancer: Use of Kinetic Modeling of Dynamic Contrast-Enhanced CT Data to Predict Clinical Outcome
Koh TS et al.
Radiology 2013; 267:145-154 - “The prediction of 5-year overall survival in this patient group varied according to the model used, with only distributed parameter-derived extravascular extracellular space volume (threshold value: 15.48 ml/100 ml) remaining predictive of 5 year overall survival once cross validayion and permuatation testing was performed; patients with a higher extravascular extracellular space volume demonstrated poorer survival.”
Primary Colorectal Cancer: Use of Kinetic Modeling of Dynamic Contrast-Enhanced CT Data to Predict Clinical Outcome
Koh TS et al.
Radiology 2013; 267:145-154
- “ Tumor angiogenesis is essential for cancer growth and provides an attractive target for oncologic therapies. CT perfusion is an emerging imaging tool that provides both qualitative and quantitative information regarding tumor angiogenesis.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - “ CT perfusion parameters may represent the alteration of blood flow,blood volume and permeability in tumor vessels secondary to their structural (chaotic structure, heterogeneity of vascular density, and dilated capillary bed) and functional (high permeability to macromolecules, intermittent flow, or arteriovenous shunts) abnormalities.”
CT Perfusion in Oncologic Imaging: A Useful Tool-
Garcia-Figueiras R et al.
AJR 2013; 200:8-19 - Perfusion CT may allow;
- Prognostic biomarkerand response prediction
- Predictive biomarker prior to therapy
- Response assessment enhancement
- Response assessment - Dual Energy CT: Liver Applications
- Virtual non-contrast CT which can result in decreased radiation dose
- Enhanced ability to detect vascular lesions in the liver (80-100 kVP)