Skip to main content

Advertisement

SpringerLink
Log in

Relationship between CT volumetric measurements and Doppler perfusion indices in gastrointestinal liver metastasis

  • Abdominal Radiology
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

This study investigated how the volume of hepatic metastatic lesions can affect liver haemodynamics and whether these perfusion parameters may help to differentiate benign and malignant liver lesions.

Materials and methods

The Doppler perfusion index (DPI the ratio of arterial to total liver blood flow) was measured in 46 patients aged 29–83 years, exhibiting up to four focal hyperechoic liver lesions at ultrasound examination. They comprised histopathologically proven liver metastasis of colorectal (19 cases) and gastric (10 cases) adenocarcinoma without local recurrence at the site of the previously resected primary tumour, along with 17 subjects with haemangioma. All patients underwent volumetric assessment using multislice computed tomography to calculate total volume of hepatic lesions.

Results

The mean DPI of patients with colorectal (36 ± 2 %) and gastric (39 ± 6 %) metastasis was significantly higher than those with haemangioma (14 ± 2 %) (both p < 0.001), whereas metastatic groups did not exhibit any difference in terms of mean DPI. Statistically significant correlations were found between DPI values and calculated total volume of lesions in patients with colorectal and gastric metastasis (r = 0.55, p = 0.01 and r = 0.85, p = 0.002, respectively) while this correlation was not demonstrated in the haemangioma group. Simple linear regression analysis revealed that every 1 cm3 increment in total volume of metastatic lesions increased DPI by 0.2 % [95 % confidence interval (CI) 0.1–0.3, p = 0.001].

Conclusion

Doppler perfusion index alterations are directly correlated with total volume of metastatic deposits, and DPI measurement can be a valuable method to distinguish haemangioma from hyperechoic colorectal and gastric metastatic lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jemal A, Bray F, Center MM et al (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  2. Cunningham D, Atkin W, Lenz HJ et al (2010) Colorectal cancer. Lancet 375:1030–1047

    Article  PubMed  Google Scholar 

  3. Ruers T, Bleichrodt RP (2002) Treatment of liver metastases, an update on the possibilities and results. Eur J Cancer 38:1023–1033

    Article  CAS  PubMed  Google Scholar 

  4. Ferlay J, Shin HR, Bray F et al. (2010) GLOBOCAN 2008 v2.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 10 [Internet], International Agency for Research on Cancer, Lyon. Available from: http://globocan.iarc.fr. Accessed 5 Apr 2013

  5. Sakamoto Y, Ohyama S, Yamamoto J et al (2003) Surgical resection of liver metastases of gastric cancer: an analysis of a 17-year experience with 22 patients. Surgery 133:507–511

    Article  PubMed  Google Scholar 

  6. Okano K, Maeba T, Ishimura K et al (2002) Hepatic resection for metastatic tumours from gastric cancer. Ann Surg 235:86–91

    Article  PubMed Central  PubMed  Google Scholar 

  7. Leen E, Goldberg JA, Robertson J et al (1991) The use of duplex sonography in the detection of colorectal hepatic metastases. Br J Cancer 63:323–325

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  8. Leen E, Goldberg JA, Robertson J et al (1991) Detection of hepatic metastases using duplex/color Doppler sonography. Ann Surg 214:599–604

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Leen E, Angerson WJ, Wotherspoon H et al (1994) Comparison of the Doppler perfusion index and intraoperative ultrasonography in diagnosing colorectal liver metastases. evaluation with postoperative follow-up results. Ann Surg 220:663–667

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Leen E, Anderson JR, Robertson J et al (1997) Doppler index perfusion in the detection of hepatic metastases secondary to gastric carcinoma. Am J Surg 173:99–102

    Article  CAS  PubMed  Google Scholar 

  11. Leen E, Angerson WJ, Wotherspoon H et al (1995) Detection of colorectal liver metastases: comparison of laparotomy, CT, US, and Doppler perfusion index and evaluation of postoperative follow-up results. Radiology 195:113–116

    Article  CAS  PubMed  Google Scholar 

  12. Fuentes MA, Keith CJ, Griffiths M et al (2002) Hepatic haemodynamics: interrelationships between contrast enhancement and perfusion on CT and Doppler perfusion indices. Br J Radiol 75:17–23

    Article  CAS  PubMed  Google Scholar 

  13. Semelka RC, Sofka CM (1997) Hepatic hemangiomas. Magn Reson Imaging Clin N Am 5:241–253

    CAS  PubMed  Google Scholar 

  14. Leen E, Angerson WG, Cooke TG, McArdle CS (1996) Prognostic power of Doppler perfusion index in colorectal cancer. correlation with survival. Ann Surg 223:199–203

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  15. Leen E, Goldberg JA, Angerson WJ, McArdle CS (2000) Potential role of Doppler perfusion index in selection of patients with colorectal cancer for adjuvant chemotherapy. Lancet 355:34–37

    Article  CAS  PubMed  Google Scholar 

  16. Pandharipande PV, Krinsky GA, Rusinek H, Lee VS (2005) Perfusion imaging of the liver: current challenges and future goals. Radiology 234:661–673

    Article  PubMed  Google Scholar 

  17. Leveson SH, Wiggins PA, Giles GR, Robinson PJ et al (1985) Deranged liver blood flow in the detection of liver metastases. Br J Surg 72:128–130

    Article  CAS  PubMed  Google Scholar 

  18. Hunt TM, Flowerdew AD, Britten AJ et al (1989) An association between parameters of liver blood flow and percentage hepatic replacement with tumour. Br J Cancer 59:410–414

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Carter R, Anderson JH, Cooke TG et al (1994) Splanchnic blood flow changes in the presence of hepatic tumour: evidence of a humoral mediator. Br J Cancer 69:1025–1026

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  20. Oppo K, Leen E, Angerson WJ, McArdle CS (2000) The effect of resecting the primary tumour on the Doppler perfusion index in patients with colorectal cancer. Clin Radiol 55:791–793

    Article  CAS  PubMed  Google Scholar 

  21. Oktar SO, Yücel C, Demirogullari T et al (2006) Doppler sonographic evaluation of hemodynamic changes in colorectal liver metastases relative to liver size. J Ultrasound Med 25:575–582

    PubMed  Google Scholar 

  22. Yarmenitis SD, Kalogeropoulou CP, Hatjikondi O et al (2000) An experimental approach of the Doppler perfusion index of the liver in detecting occult hepatic metastases: histological findings related to the hemodynamic measurements in Wistar rats. Eur Radiol 10:417–424

    Article  CAS  PubMed  Google Scholar 

  23. Kruskal JB, Thomas P, Kane RA, Goldberg SN (2004) Hepatic perfusion changes in mice livers with developing colorectal cancer metastases. Radiology 231:482–490

    Article  PubMed  Google Scholar 

  24. Haugeberg G, Strohmeyer T, Lierse W, Böcker W (1988) The vascularization of liver metastases. histological investigation of gelatine-injected liver specimens with special regard to the vascularization of micrometastases. J Cancer Res Clin Oncol 114:415–419

    Article  CAS  PubMed  Google Scholar 

  25. Nikfarjam M, Muralidharan V, Malcontenti-Wilson C, Christophi C (2003) Scanning electron microscopy study of the blood supply of human colorectal liver metastases. Eur J Surg Oncol 29:856–861

    Article  CAS  PubMed  Google Scholar 

  26. Roumen RM, Scheltinga MR, Slooter GD, van der Linden AW (2005) Doppler perfusion index fails to predict the presence of occult hepatic colorectal metastases. Eur J Surg Oncol 31:521–527

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

Amir Reza Radmard, Alireza Abrishami, Ali Gholamrezanezhad, Shadi Kolahdoozan, Nahid Sedighi, Amir Pejman Hashemi Taheri declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 14114, Iran

    Amir Reza Radmard, Alireza Abrishami, Nahid Sedighi & Amir Pejman Hashemi Taheri

  2. Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, North Kargar Ave., Tehran, 14117-13135, Iran

    Amir Reza Radmard & Shadi Kolahdoozan

  3. Department of Radiology, Case Medical Center, Case Western Reserve University, Cleveland, OH, USA

    Ali Gholamrezanezhad

Authors
  1. Amir Reza Radmard
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alireza Abrishami
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ali Gholamrezanezhad
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shadi Kolahdoozan
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nahid Sedighi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Amir Pejman Hashemi Taheri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Amir Pejman Hashemi Taheri.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Radmard, A.R., Abrishami, A., Gholamrezanezhad, A. et al. Relationship between CT volumetric measurements and Doppler perfusion indices in gastrointestinal liver metastasis. Radiol med 120, 171–179 (2015). https://doi.org/10.1007/s11547-014-0423-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11547-014-0423-y

Keywords

Search

Navigation