Digestive Diseases and Sciences

, Volume 52, Issue 4, pp 943–949 | Cite as

Quantitative Tissue Blood Flow Measurement of the Liver Parenchyma: Comparison Between Xenon CT and Perfusion CT

  • Kazuhiko Hashimoto
  • Takamichi Murakami
  • Keizo Dono
  • Masatoshi Hori
  • Tonsok Kim
  • Masayuki Kudo
  • Shigeru Marubashi
  • Atsushi Miyamoto
  • Yutaka Takeda
  • Hiroaki Nagano
  • Koji Umeshita
  • Hironobu Nakamura
  • Morito Monden
Original Article

Abstract

The purpose of this study was to compare measurements of hepatic tissue blood flow (TBF) calculated by xenon and perfusion CT. Seven patients with normal liver and eight with chronic liver disease underwent both xenon and perfusion CT. During xenon CT examinations, serial abdominal CT scans were obtained every minute before and during 4 min of nonradioactive 25% (v/v) xenon gas inhalation and 5 min of administration of oxygen-rich air. Hepatic arterial and portal venous TBF were measured separately with a special imaging system using the Kety-Schmidt expression based on the Fick principle (AZ-7000W; Anzai Medical Co.). The hepatic arterial fraction (HAF) was calculated as follows: [hepatic arterial TBF/(hepatic arterial TBF + portal venous TBF)]. During perfusion CT examinations, total hepatic TBF and HAF were also calculated from the enhanced CT cine image data on a workstation using a commercially available software package based on a deconvolution algorithm (CT Perfusion 3 GE Healthcare, USA). Total hepatic TBF measured by xenon and perfusion CT was 82.9±15 and 82.8±18 ml/min/100 g, respectively. The measured values by the two techniques showed a significant correlation (R 2= 0.657, P < 0.05). HAF measured by xenon and perfusion CT was 26.6±11 and 21.8±13%, respectively. The measured values by the two techniques also showed a significant correlation (R 2= 0.869, P < 0.05). We conclude that there was a good correlation between hepatic TBF quantified by xenon CT and perfusion CT.

Keywords

Hepatic tissue blood flow Xenon CT Perfusion CT Hepatic arterial tissue blood flow Portal venous tissue blood flow Hepatic arterial fraction 

References

  1. 1.
    Leen E, Goldberg JA, Anderson JR, Robertson J, Moule B, Cook TG, Mcardle CS (1993) Hepatic perfusion changes in patients with liver metastases: comparison with those patients with cirrhosis. Gut 34:554–557PubMedGoogle Scholar
  2. 2.
    Tsushima Y, Blomley MJ, Kusano S, Endo K (1999) The portal component of hepatic perfusion measured by dynamic CT: an indicator of hepatic parenchymal damage. Dig Dis Sci 44:1632–1638PubMedCrossRefGoogle Scholar
  3. 3.
    Lautt WW (1985) Mechanism and role of intrinsic regulation of hepatic arterial blood flow: hepatic arterial buffer response. Am J Physiol 249:G549–G556PubMedGoogle Scholar
  4. 4.
    Kleber G, Steudel N, Behrmann C, Zipprich A, Hubner G, Lotterer E, Fleig WE (1999) Hepatic arterial flow volume and reserve in patients with cirrhosis: use of intra-arterial Doppler and adenosine infusion. Gastroenterology 116:906–914PubMedCrossRefGoogle Scholar
  5. 5.
    Johnson DJ, Muhlbacher F, Wilmore DW (1985) Measurement of hepatic blood flow. J Surg Res 39:470–481PubMedCrossRefGoogle Scholar
  6. 6.
    Zeeh J, Lange H, Bosch J, Pohl S, Loesgen H, Eggers R, Navasa M, Chesta J, Bircher J (1988) Steady-state extrarenal sorbitol clearance as a measure of hepatic plasma flow. Gastroenterology 95:749–759PubMedGoogle Scholar
  7. 7.
    Miles KA, Hayball MP, Dixon AK (1993) Functional images of hepatic perfusion obtained with dynamic CT. Radiology 188:405–411PubMedGoogle Scholar
  8. 8.
    Ziegler SI, Haberkorn U, Byrne H, Tong C, Kaja S, Richolt JA, Byrne H, Tong C, Schosser R, Krieter H, Kaja S, Richolt JA, Lammertsma AA, Price P (1996) Measurement of liver blood flow using oxygen-15 labelled water and dynamic positron emission tomography: limitations of model description. Eur J Nucl Med 23:169–177Google Scholar
  9. 9.
    Taourel P, Blanc P, Dauzat M, Chabre M, Pradel J, Gallix B, Larrey D, Bruel JM (1998) Doppler study of mesenteric, hepatic, and portal circulation in alcoholic cirrhosis: relationship between quantitative Doppler measurements and the severity of portal hypertension and hepatic failure. Hepatology 28:932–936PubMedCrossRefGoogle Scholar
  10. 10.
    Reichen J (1995) Assessment of hepatic function with xenobiotics. Semin Liver Dis 15:189–201PubMedCrossRefGoogle Scholar
  11. 11.
    Gur D, Good WF, Herbert DL, Yonas H, Wozney P, Van Thiel DH, Wolfson SK Jr (1985) Blood flow mapping in the human liver by the xenon/CT method. J Comput Assist Tomogr 9:447–450PubMedCrossRefGoogle Scholar
  12. 12.
    Sase S, Monden M, Oka H, Dono K, Fukuta T, Shibata I (2002) Hepatic blood flow measurements with arterial and portal blood flow mapping in human liver by means of xenon CT. J Comput Assist Tomogr 26:243–249PubMedCrossRefGoogle Scholar
  13. 13.
    Bader TR, Herneth AM, Blaicher W, Steininger R, Mühlbacher F, Lechner G, Grabenwoger F (1998) Hepatic perfusion after liver transplantation: noninvasive measurement with dynamic single-section CT. Radiology 209:129–134PubMedGoogle Scholar
  14. 14.
    Van Beers BE, Leconte I, Materne R, Smith AM, Jamart J, Horsmans Y (2001) Hepatic perfusion parameters in chronic liver disease: dynamic CT measurements correlated with disease severity. AJR Am J Roentgenol 176:667–673PubMedGoogle Scholar
  15. 15.
    Lee TY (2002) Functional CT: physiological models. Trends Biotechnol 20:S3–S10CrossRefGoogle Scholar
  16. 16.
    Blomley MJ, Lim AK, Harvey CJ, Patel N, Eckersley RJ, Basilico R, Heckemann R, Urbank A, Cosgrove DO, Taylor-Robinson SD (2003) Liver microbubble transit time compared with histology and Child-Pugh score in diffuse liver disease: A cross sectional study. Gut 52:1188–1193PubMedCrossRefGoogle Scholar
  17. 17.
    World Medical Association (2000) Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 284:3043–3045CrossRefGoogle Scholar
  18. 18.
    Kalender WA, Polacin A, Eidloth H, Kashiwagi S, Yamashita T, Nakano S (1991) Brain perfusion studies by xenon-enhanced CT using washin/washout study protocols. J Comput Assist Tomogr 15:816–822PubMedCrossRefGoogle Scholar
  19. 19.
    Kety S (1951) The theory and applications of the exchange of inert gas at the lungs and tissue. Pharmacol Rev 3:1–41PubMedGoogle Scholar
  20. 20.
    Fick A (1870) Uber die Messung des Blutquantums in den Herzventrikeln Verhandl dphys-med Ges zu Wurzburg 2:16–28Google Scholar
  21. 21.
    Sase S (1996) Correction method for end-tidal xenon concentration in CBF measurements with xenon-enhanced CT. J Comput Assist Tomogr 20:688–692PubMedCrossRefGoogle Scholar
  22. 22.
    Meyer JS, Hayman LA, Yamamoto M, Sakai F, Nakajima S (1980) Local cerebral blood flow measured by CT after stable xenon inhalation. AJR Am J Roentgenol 135:239–251PubMedGoogle Scholar
  23. 23.
    Frackowiak RS, Lenzi GL, Jones T, Heather JD (1980) Quantitative measurement of regional cerebral blood flow and oxygen metabolism in man using 15O and positron emission tomography: theory, procedure, and normal values. J Comput Assist Tomogr 4:727–736PubMedCrossRefGoogle Scholar
  24. 24.
    Brasch RC, Weinmann HJ, Wesbey GE (1984) Contrast-enhanced NMR imaging: animal studies using gadolinium-DTPA complex. AJR Am J Roentgenol 142:625–630PubMedGoogle Scholar
  25. 25.
    Winkler SS, Holden JE, Sackett JF, Flemming DC, Alexander SC (1977) Xenon and krypton as radiographic inhalation contrast media with computerized tomography: preliminary note. Invest Radiol 12:19–20PubMedCrossRefGoogle Scholar
  26. 26.
    Miles KA (1991) Measurement of tissue perfusion by dynamic computed tomography. Br J Radiol 64:409–412PubMedCrossRefGoogle Scholar
  27. 27.
    Latchaw RE, Yonas H, Pentheny SL, Gur D (1987) Adverse reactions to xenon-enhanced CT cerebral blood flow determination. Radiology 163:251–254PubMedGoogle Scholar
  28. 28.
    Okumura M, Toyoshima N, Katada K, Sasaki M (2003) Performance evolution for image filters used for CT images. Radiological Society of North America. 89th Scientific assembly and annual meeting program: 720Google Scholar

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Kazuhiko Hashimoto
    • 1
  • Takamichi Murakami
    • 2
  • Keizo Dono
    • 1
  • Masatoshi Hori
    • 2
  • Tonsok Kim
    • 2
  • Masayuki Kudo
    • 3
  • Shigeru Marubashi
    • 1
  • Atsushi Miyamoto
    • 1
  • Yutaka Takeda
    • 1
  • Hiroaki Nagano
    • 1
  • Koji Umeshita
    • 1
  • Hironobu Nakamura
    • 2
  • Morito Monden
    • 1
  1. 1.Department of Surgery, Graduate School of MedicineOsaka UniversityOsakaJapan
  2. 2.Department of Radiology, Graduate School of MedicineOsaka UniversityOsakaJapan
  3. 3.Imaging Application Tech Center GE Yokogawa Medical SystemsTokyoJapan

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