Skip to main content

Advertisement

SpringerLink
Log in

Can quantitative iodine parameters on DECT replace perfusion CT parameters in colorectal cancers?

  • Gastrointestinal
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To determine the correlation between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT (PCT) parameters in patients with pathologically proven colorectal cancers (CRC) and to evaluate their reproducibility and respective radiation exposures.

Methods

Institutional review board approval and written informed consents were obtained for this study. Forty-one patients with CRCs who underwent same-day DECT and PCT were prospectively enrolled. Three radiologists independently analyzed the iodine concentration of the tumors and iodine ratios [ratio of lesion to aorta (IRa) or to infrarenal IVC (IRv)] from DECT as well as blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) from PCT. Pearson R and linear correlation, paired t-test, and intraclass correlation coefficients (ICCs) were used.

Results

Significant correlations were found between iodine parameters from DECT and PCT parameters: iodine concentration of tumors and BV (r = 0.32, p = 0.04), PMB (r = 0.34, p = 0.03), and MTT (r = -0.38, p = 0.02); iodine ratio (IRa) and MTT (r = -0.32, p = 0.04); iodine ratio (IRv) and BF (r = 0.32, p = 0.04) and PMB (r = 0.44, p = <0.01). DECT showed better intra- and interobserver agreements (ICC = 0.98, 0.90 in iodine concentration; 0.98, 0.91 in IRa; and 0.91, 0.93 in IRv, respectively) than PCT (ICC = 0.90, 0.78 in BF; 0.82, 0.76 in BV; 0.75, 0.75 in PMB; 0.64, 0.79 in MTT, respectively). As for radiation dosage, CTDIvol and DLP in DECT (10.48 ± 1.84 mGy and 519.7 ± 116.7 mGy·cm) were significantly lower than those of PCT (75.76 mGy and 911 mGy·cm) (p < 0.01).

Conclusion

Iodine parameters from DECT are significantly correlated with PCT parameters, but have higher intra- and interobserver agreements and lower radiation exposure.

Key Points

• Quantitative iodine concentrations from DECT are significantly correlated with perfusion CT parameters.

• Intra- and interobserver agreements of DECT are better than those of perfusion CT.

• Effective radiation doses of DECT are significantly lower than those of perfusion CT.

• DECT can be used as an alternative to perfusion CT with lower radiation doses.

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
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

BF:

Blood flow

BV:

Blood volume

CRC:

Colorectal cancer

CTDIvol:

Computed tomography dose index volume

DECT:

Dual-energy CT

DLP:

Dose length product

ICC:

Intraclass correlation coefficient

ICt:

Iodine concentration

IRa:

Iodine concentration ratio of the tumor to aorta

IRv:

Iodine concentration ratio of the tumor to inferior vena cava

IVC:

Inferior vena cava

MTT:

Mean transit time

MVD:

Microvessel density

PCT:

Perfusion CT

PMB:

Permeability surface area product

ROI:

Region of interest

VEGF:

Vascular endothelial growth factor

References

  1. Ajiki T, Fujimori T, Ikehara H, Saitoh Y, Maeda S (1995) K-ras gene mutation related to histological atypias in human colorectal adenomas. Biotech Histochem 70:90–94

    Article  CAS  Google Scholar 

  2. Rak J, Mitsuhashi Y, Bayko L et al (1995) Mutant ras oncogenes upregulate VEGF/VPF expression: implications for induction and inhibition of tumor angiogenesis. Cancer Res 55:4575–4580

    CAS  PubMed  Google Scholar 

  3. Des Guetz G, Uzzan B, Nicolas P et al (2006) Microvessel density and VEGF expression are prognostic factors in colorectal cancer. Meta-analysis of the literature. Br J Cancer 94:1823

    Article  CAS  Google Scholar 

  4. Lee JC, Chow NH, Wang ST, Huang SM (2000) Prognostic value of vascular endothelial growth factor expression in colorectal cancer patients. Eur J Cancer 36:748–753

    Article  CAS  Google Scholar 

  5. Sahani DV, Holalkere N-S, Mueller PR, Zhu AX (2007) Advanced hepatocellular carcinoma: CT perfusion of liver and tumor tissue—initial experience. Radiology 243:736–743

    Article  Google Scholar 

  6. Kim JW, Jeong YY, Chang NK et al (2012) Perfusion CT in colorectal cancer: comparison of perfusion parameters with tumor grade and microvessel density. Korean J Radiol 13 Suppl 1:S89–S97

    Article  Google Scholar 

  7. Goh V, Halligan S, Daley F, Wellsted DM, Guenther T, Bartram CI (2008) Colorectal tumor vascularity: quantitative assessment with multidetector CT—do tumor perfusion measurements reflect angiogenesis? Radiology 249:510–517

    Article  Google Scholar 

  8. Sahani DV, Kalva SP, Hamberg LM et al (2005) Assessing tumor perfusion and treatment response in rectal cancer with multisection CT: initial observations. Radiology 234:785–792

    Article  Google Scholar 

  9. Morsbach F, Pfammatter T, Reiner CS et al (2013) Computed tomographic perfusion imaging for the prediction of response and survival to transarterial radioembolization of liver metastases. Invest Radiol 48:787–794

    Article  Google Scholar 

  10. Maaß C, Baer M, Kachelrieß M (2009) Image-based dual energy CT using optimized precorrection functions: A practical new approach of material decomposition in image domain. Med Phys 36:3818–3829

    Article  Google Scholar 

  11. Goo HW, Goo JM (2017) Dual-energy CT: new horizon in medical imaging. Korean J Radiol 18:555–569

    Article  Google Scholar 

  12. Marin D, Boll DT, Mileto A, Nelson RC (2014) State of the art: dual-energy CT of the abdomen. Radiology 271:327–342

    Article  Google Scholar 

  13. Agrawal MD, Pinho DF, Kulkarni NM, Hahn PF, Guimaraes AR, Sahani DV (2014) Oncologic applications of dual-energy CT in the abdomen. Radiographics 34:589–612

    Article  Google Scholar 

  14. Morgan DE (2014) Dual-energy CT of the abdomen. Abdom Imaging 39:108–134

    Article  Google Scholar 

  15. Stiller W, Skornitzke S, Fritz F et al (2015) Correlation of quantitative dual-energy computed tomography iodine maps and abdominal computed tomography perfusion measurements: are single-acquisition dual-energy computed tomography iodine maps more than a reduced-dose surrogate of conventional computed tomography perfusion? Invest Radiol 50:703–708

    Article  Google Scholar 

  16. Gordic S, Puippe GD, Krauss B et al (2016) Correlation between dual-energy and perfusion CT in patients with hepatocellular carcinoma. Radiology 280:78–87

    Article  Google Scholar 

  17. Fuld MK, Halaweish AF, Haynes SE, Divekar AA, Guo J, Hoffman EA (2013) Pulmonary perfused blood volume with dual-energy CT as surrogate for pulmonary perfusion assessed with dynamic multidetector CT. Radiology 267:747–756

    Article  Google Scholar 

  18. Goh V, Halligan S, Gharpuray A, Wellsted D, Sundin J, Bartram CI (2008) Quantitative assessment of colorectal cancer tumor vascular parameters by using perfusion CT: influence of tumor region of interest. Radiology 247:726–732

    Article  Google Scholar 

  19. Bongartz G, Golding S, Jurik A et al (2004) European guidelines for multislice computed tomography. European Commission

  20. Bellomi M, Petralia G, Sonzogni A, Zampino MG, Rocca A (2007) CT perfusion for the monitoring of neoadjuvant chemotherapy and radiation therapy in rectal carcinoma: initial experience. Radiology 244:486–493

    Article  Google Scholar 

Download references

Funding

This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2016R1A2B4007762).

Author information

Authors and Affiliations

  1. Department of Radiology, Seoul National University Hospital, Seoul, Korea

    Hyo-Jin Kang, Se Hyung Kim, Jae Seok Bae, Sun Kyung Jeon & Joon Koo Han

  2. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Hyo-Jin Kang, Se Hyung Kim, Jae Seok Bae, Sun Kyung Jeon & Joon Koo Han

  3. Department of Radiology, Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Korea

    Joon Koo Han

Authors
  1. Hyo-Jin Kang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Se Hyung Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Seok Bae
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sun Kyung Jeon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Joon Koo Han
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Se Hyung Kim.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Se Hyung Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• cross-sectional study

• performed at one institution

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kang, HJ., Kim, S.H., Bae, J.S. et al. Can quantitative iodine parameters on DECT replace perfusion CT parameters in colorectal cancers?. Eur Radiol 28, 4775–4782 (2018). https://doi.org/10.1007/s00330-018-5502-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-018-5502-3

Keywords

Search

Navigation