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Quantitative Tumor Perfusion Assessment with Multidetector CT: Are Measurements from Two Commercial Software Packages Interchangeable?¹

¹ From the Paul Strickland Scanner Centre, Mount Vernon Hospital, Northwood, England (V.G.); Department of Academic Radiology, University College London, University College Hospital, 235 Euston Road, Level 2 Podium, London NW1 2BU, England (S.H.); and Intestinal Imaging Centre, St Mark's Hospital, Harrow, England (C.I.B.). Received February 13, 2006; revision requested April 18; revision received May 18; final version accepted July 7. Address correspondence to S.H. (e-mail: s.halligan{at}ucl.ac.uk).

Purpose: To prospectively determine the level of agreement between tumor blood volume and permeability measurements obtained with two commercially available perfusion computed tomographic (CT) software packages.

Materials and Methods: This study was performed with institutional review board approval; informed consent was obtained from all participants. A total of 44 patients (24 men, 20 women; mean age, 68 years; range, 28–87 years) with proved colorectal cancer were examined prospectively with multi–detector row CT. A 65-second tumor perfusion study was performed after intravenous bolus injection of contrast material. Tumor blood volume and permeability were determined with two methods: adiabatic approximation of distributed parameter analysis and Patlak analysis. Agreement between the results was determined by using Bland-Altman statistics. Within-patient variation was determined by using analysis of variance.

Results: The mean values for permeability and blood volume, respectively, were 13.9 mL · 100 mL^–1 · min^–1 ± 3.7 (standard deviation) and 6.1 mL/100 mL ± 1.5, as calculated with distributed parameter analysis, and 17.4 mL · 100 mL^–1 · min^–1 ± 7.3 and 10.1 mL/100 mL ± 4.2, as calculated with Patlak analysis. The mean difference and 95% limits of agreement, respectively, were –3.6 mL · 100 mL^–1 · min^–1 and –18.4 to 11.2 mL · 100 mL^–1 · min^–1 for permeability and –3.9 mL/100 mL and –10.9 to 3.0 mL/100 mL for blood volume. The coefficient of variation was 37.4% for permeability and 46.5% for blood volume.

Conclusion: There was disagreement between the methods used to estimate tumor vascularity, which indicated the measurement techniques were not directly interchangeable.

© RSNA, 2007

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