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Assessment of tumor vascularization in pancreatic adenocarcinoma using 128-slice perfusion computed tomography imaging

Louke Delrue (UGent) , PETER BLANCKAERT (UGent) , Dokus Mertens, Ercan Cesmeli (UGent) , Wim Ceelen (UGent) and Philippe Duyck (UGent)
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Abstract
Objective: Computed tomography (CT) perfusion studies can provide valuable information regarding tumor vascularization. We report on a study assessing CT perfusion characteristics in the normal pancreas and in patients with pancreatic adenocarcinoma. Methods: Twenty healthy subjects and 20 patients with histologically confirmed pancreatic adenocarcinoma were included in the study after written informed consent and approval by our institutional review board. All subjects underwent perfusion CT imaging of the pancreas using 128-slice dual-source CT. The scanning sequence included 18 scans. Parametric maps of blood volume (BV), blood flow (BF), and permeability surface area product (PS) were generated and compared with density measurements. Results: In normal pancreas, no significant difference in perfusion values was observed between head, body, and tail of the pancreas. Mean organ values were 76.76 (SD, 15.6) mL/100 g/min, 15.80 (SD, 2.40) mL/100 g, and 27.74 (SD, 16.8) mL/100 g/min for BF, BV, and PS, respectively. Compared with the normal pancreas, a 60% reduction in BF and BV was observed in the tumor tissue. Perfusion values gradually increased toward the tumor rim. Necrotic tumor areas were identified in 25% of patients. No significant differences were observed when comparing normal pancreas and healthy pancreatic tissue in adenocarcinoma patients. Conclusions: The feasibility of whole-tumor perfusion imaging using 128-slice CT was demonstrated in patients with pancreatic adenocarcinoma. Perfusion CT provides additional information compared with image assessment based on density measurements (Hounsfield units) and allows noninvasive assessment of vascularization in the tumor tissue.
Keywords
adenocarcinoma, SOFTWARE QUANTITATIVE-ANALYSIS, pancreas, perfusion CT, abdominal CT, ACUTE STROKE PATIENTS, CT REFLECTS ANGIOGENESIS, IDENTICAL SOURCE DATA, BLOOD-FLOW, PROGNOSTIC-FACTORS, ENDOCRINE TUMORS, CANCER, MAPS, CARCINOMA

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Chicago
Delrue, Louke, PETER BLANCKAERT, Dokus Mertens, Ercan Cesmeli, Wim Ceelen, and Philippe Duyck. 2011. “Assessment of Tumor Vascularization in Pancreatic Adenocarcinoma Using 128-slice Perfusion Computed Tomography Imaging.” Journal of Computer Assisted Tomography 35 (4): 434–438.
APA
Delrue, L., BLANCKAERT, P., Mertens, D., Cesmeli, E., Ceelen, W., & Duyck, P. (2011). Assessment of tumor vascularization in pancreatic adenocarcinoma using 128-slice perfusion computed tomography imaging. JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY, 35(4), 434–438.
Vancouver
1.
Delrue L, BLANCKAERT P, Mertens D, Cesmeli E, Ceelen W, Duyck P. Assessment of tumor vascularization in pancreatic adenocarcinoma using 128-slice perfusion computed tomography imaging. JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY. 2011;35(4):434–8.
MLA
Delrue, Louke, PETER BLANCKAERT, Dokus Mertens, et al. “Assessment of Tumor Vascularization in Pancreatic Adenocarcinoma Using 128-slice Perfusion Computed Tomography Imaging.” JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY 35.4 (2011): 434–438. Print.
@article{1898628,
  abstract     = {Objective: Computed tomography (CT) perfusion studies can provide valuable information regarding tumor vascularization. We report on a study assessing CT perfusion characteristics in the normal pancreas and in patients with pancreatic adenocarcinoma. 
Methods: Twenty healthy subjects and 20 patients with histologically confirmed pancreatic adenocarcinoma were included in the study after written informed consent and approval by our institutional review board. All subjects underwent perfusion CT imaging of the pancreas using 128-slice dual-source CT. The scanning sequence included 18 scans. Parametric maps of blood volume (BV), blood flow (BF), and permeability surface area product (PS) were generated and compared with density measurements. 
Results: In normal pancreas, no significant difference in perfusion values was observed between head, body, and tail of the pancreas. Mean organ values were 76.76 (SD, 15.6) mL/100 g/min, 15.80 (SD, 2.40) mL/100 g, and 27.74 (SD, 16.8) mL/100 g/min for BF, BV, and PS, respectively. Compared with the normal pancreas, a 60\% reduction in BF and BV was observed in the tumor tissue. Perfusion values gradually increased toward the tumor rim. Necrotic tumor areas were identified in 25\% of patients. No significant differences were observed when comparing normal pancreas and healthy pancreatic tissue in adenocarcinoma patients. 
Conclusions: The feasibility of whole-tumor perfusion imaging using 128-slice CT was demonstrated in patients with pancreatic adenocarcinoma. Perfusion CT provides additional information compared with image assessment based on density measurements (Hounsfield units) and allows noninvasive assessment of vascularization in the tumor tissue.},
  author       = {Delrue, Louke and BLANCKAERT, PETER and Mertens, Dokus and Cesmeli, Ercan and Ceelen, Wim and Duyck, Philippe},
  issn         = {0363-8715},
  journal      = {JOURNAL OF COMPUTER ASSISTED TOMOGRAPHY},
  keyword      = {adenocarcinoma,SOFTWARE QUANTITATIVE-ANALYSIS,pancreas,perfusion CT,abdominal CT,ACUTE STROKE PATIENTS,CT REFLECTS ANGIOGENESIS,IDENTICAL SOURCE DATA,BLOOD-FLOW,PROGNOSTIC-FACTORS,ENDOCRINE TUMORS,CANCER,MAPS,CARCINOMA},
  language     = {eng},
  number       = {4},
  pages        = {434--438},
  title        = {Assessment of tumor vascularization in pancreatic adenocarcinoma using 128-slice perfusion computed tomography imaging},
  url          = {http://dx.doi.org/10.1097/RCT.0b013e318223f0c5},
  volume       = {35},
  year         = {2011},
}

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