Feasibility of integrated CT-liver perfusion in routine FDG-PET/CT

Veit-Haibach, Patrick ; Treyer, Valerie ; Strobel, Klaus ; Soyka, Jan ; Husmann, Lars ; Schaefer, Niklaus ; Tschopp, Alois ; Hany, Thomas

In: Abdominal Imaging, 2010, vol. 35, no. 5, p. 528-536

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    Objective: To integrate CT-perfusion into a routine, clinical contrast-enhanced (ce) PET/CT protocol for the evaluation of liver metastases and to compare functional CT and PET parameters. Materials and methods: Forty-six consecutive patients (mean age: 60 (34-82) years; 20 f, 26m) with known liver lesions (colorectal metastases (n=34), primary liver cancer (n=4), breast cancer (n=3), anal cancer, gastric cancer, esophageal cancer, GIST, duodenal cancer (all: n=1) who were referred for staging or therapy follow-up by [18F]-Fluoro-2-deoxy-D-glucose-positron-emission-tomography/computed-tomography imaging (FDG-PET/CT) were included. After acquisition of a low-dose PET/CT, a split-injection (70-90mL) ce-CT-protocol, including a 35-s CT-perfusion scan of the liver and a diagnostic ce-CT of the thorax and/or abdomen (70s delay, iv-contrast volume: 90mL, 4mL/s) was performed. CT-perfusion parameters (BF, BV, MTT,) and semi-quantitative PET-parameters (SUVmax, SUVmean, TLG, PETvol) were analyzed and compared. Results: CT-perfusion data could be obtained in all but one patient with shallow breathing. In all patients, diagnostic ce-PET/CT quality was adequate without the use of additional contrast media. Significant correlations (P<0.05) were found for each of BF, BV, MTT, and SUVmax, further, BF and MTT correlated with TLG. Several other correlations were seen for other perfusion and PET-parameters. Conclusion: Combined CT-perfusion/PET/CT-protocol without the use of additional contrast media is feasible and can be easily integrated in clinical routine. Perfusion parameters and PET-parameters are only partly correlating and therefore have to be investigated further at fixed time points during the course of disease and therapy