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Spiral CT perfusion imaging in pancreatic cancer in comprehensive treatment system

Author: HuangZhenHua
Tutor: JinZhengYu
School: Beijing Union Medical College
Course: Clinical
Keywords: Pancreatic perfusion Maximum-slope model Deconvolutionarithmetic BF BV TTS TTP PM MTT and PSPancreatic perfusion Karnofsky performance Status VAS (visualanalog scale)
CLC: R735.9
Type: PhD thesis
Year: 2009
Downloads: 5
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Abstract

Purpose:To study differences of parameters between Maximum-slope model and deconvolution arithmetic in the CT perfusion scanning of pancreas, and calculate the reference values of the parameters of pancreatic perfusion in normal population. Material and method:15normal patients and16patients diagnosed as islet cell tumor pathologically or clinically underwent contrast-enhanced abdominal scanning and pancreatic perfusion scanning. Images were then transferred to workstation and perfusion parameters were calculated using Siemens Body-perfusion software and TD A(Time Density Analysis) in the Aquarius workstation from Terarecom Company. The perfusion parameters of normal people and normal pancreatic tissues of patients were compared by independent-sample t-test(confident interval95%). If there was no statistic significance, the perfusion parameters of normal pancreatic tissue of the patients were taken as data of normal population. The same perfusion parameters of maximum-slope model and deconvolution arithmetic were compared between two arithmetic and performed by paired-sample t-test. Calculate the means of perfusion parameters of normal population sample, and obtain the reference value of parameters of pancreatic perfusion in normal population. Results:There was no statistic significance between perfusion parameters of normal people and normal pancreatic tissues of patients. So the data of normal pancreatic tissue of islet cell tumors was taken as data of normal population sample. The differences of parameters between Maximum-slope model and Deconvolution arithmetic in the CT perfusion scanning of pancreas had statistic significance (p<0.001). The reference value of normal pancreatic tissue in Maximum-slope model were BF(blood flow)135.21±24.92ml·100ml-1·min-1,BV (blood volume)19.88±3.43ml·100ml-1, TTS (time to start)2.92±0.98s, TTP (time to peak)14.01±1.68s, PM (permeability)42.83±14.530.5ml-100ml-1·min-1; The reference value of normal pancreatic tissue in Deconvolution arithmetic were BF(blood flow)159.92±24.72ml·100g-1·min-1,BV (blood volume)28.96±7.67ml·100g-1, MTT (mean transit time)9.52±2.11s,TTP (time to peak)11.63±2.19s。Conclusion:The differences of parameters between Maximum-slope model and deconvolution arithmetic in the CT perfusion scanning of pancreas have statistic signifinance. No comparison between two arithmetic is made. Our reference value of normal pancreatic tissue is very similar to others’ results. But there are still some differences among them. Purpose:To evaluate the use of perfusion imaging with64-slice CT in the differential diagnosis of pancreatic masses. Material and method:15normal patients,16patients diagnosed pancreatic carcinoma pathologically or clinically,7patients diagnosed pancreatic adenoma pathologically or clinically and16patients diagnosed islet cell tumor pathologically or clinically underwent contrast-enhanced abdominal scanning and pancreatic perfusion scanning. Images were then transferred to workstation and perfusion parameters were calculated by using Siemens Body-perfusion software and TDA(Time Density Analysis) in the Aquarius workstation from Terarecom Company. Compare pancreatic carcinoma with normal pancreas, pancreatic adenoma and islet cell tumor separately. They were performed by independent-sample t-test(confident interval95%). Results:With the Maximum-slope model:pancreatic carcinoma had lower BF and BV compared with normal pancreas (P<0.05). Pancreatic carcinoma had higher TTP compared with normal pancreas (P<0.05). There was no statistic significance between pancreatic carcinoma and normal pancreas when comparing TTS and PM (P>0.05). There was no statistic significance between pancreatic carcinoma and pancreatic adenoma in all perfusion parameters. Pancreatic carcinoma had lower BF and BV compared with islet cell tumor (P<0.05). Pancreatic carcinoma had higher TTP compared with islet cell tumor (P<0.05). There was no statistic significance between pancreatic carcinoma and islet cell tumor when comparing TTS and PM (P>0.05). With the Deconvolution arithmetic:pancreatic carcinoma had lower BF and BV compared with normal pancreas (P<0.05). Pancreatic carcinoma had higher TTP compared with normal pancreas (P<0.05). There was no statistic significance between pancreatic carcinoma and normal pancreas when comparing MTT (P>0.05). There was no statistic significance between pancreatic carcinoma and pancreatic adenoma in all perfusion parameters. Pancreatic carcinoma had lower BF and BV compared with islet cell tumor (P<0.05). Pancreatic carcinoma had higher MTT and TTP compared with islet cell tumor(P<0.05). Conclusion:Pancreatic carcinoma can be differentiated from normal pancreas and islet cell tumor by CT perfusion imaging. But CT perfusion imaging has no effect in the differential diagnosis between Pancreatic carcinoma and pancreatic adenoma. Purpose:To study the use of perfusion CT for evaluating the efficacy of chemotherapy in pancreatic carcinoma patients. Material and method:Patients diagnosed as pancreatic carcinoma clinically, can not be resected by surgery and will receive chemotherapy were enrolled in our study. They received contrast-enhanced abdominal scanning and pancreatic perfusion scanning. And then they received the same scan again after several cycles of chemotherapy. At two visit point, we tested the serum tumor makers (CA19-9, CA242, CA50and CEA), evaluated physical condition and bellyache of patients. Compare perfusion parameters with tumor makers, physical condition and ache grades. Results:the changes of perfusion parameters of XIA accorded with the change of CA19-9, which indicated the illness was worse. But there was no change in the physical condition of XIA and the change of ache grades was not obvious. The result of perfusion parameters of SHEN accorded with the change of CA19-9, physical condition and ache grades, which indicated the patients progress. The result of perfusion parameters of SHEN accorded with the chang of CA19-9, physical condition and ache grades. They all indicated the condition of the patient is not change. Conclusion:Perfusion CT can be used to evaluate the efficacy of chemotherapy in pancreatic carcinoma.

Spiral CT perfusion imaging in pancreatic cancer in comprehensive treatment system

Abstract

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