Animal Experiment And Clinical Study Of Multidetector CT Perfusion Imaging In Primary Hepatic Carcinomas

PartⅠEvaluation of hemodynamic characteristics of VX2 hepatic tumors in rabbits by using multidetector CT perfusion imagingObjective: To study the hemodynamic characteristics of VX2 hepatic tumors in rabbits by using CT perfusion imaging.Materials and methods: Ten New Zealand White rabbits with VX2 hepatic tumors underwent functional CT two weeks after the VX2 hepatic tumors implantation, another eight normal New Zealand White rabbits served as control rabbits. Hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP), total liver perfusion (TLP), hepatic arterial perfusion index (HAPI) and hepatic portal perfusion index (HPPI) were measured by using a functional CT software program. Results: The HAP and HAPI values of VX2 hepatic tumors in rabbits were significantly higher than those in the control rabbits (P＜0.05), inversely, the HPP, TLP and HPPI values of VX2 hepatic tumors in rabbits were markedly lower than those in the control rabbits respectively (P＜0.05).Conclusions: The VX2 hepatic tumors in rabbits demonstrated their hemodynamic characteristics as human primary hepatic carcinomas, and CT perfusion imaging can evaluate the blood perfusion of VX2 hepatic tumors in rabbits exactly. PartⅡHemodynamic parameters correlate with angiogenesis in hepatocellular carcinomasObjective: To study the hemodynamic characteristics of hepatocellular carcinomas (HCC) and to evaluate CT perfusion imaging (CTPI) in the quantification of angiogenesis by comparing the tissue perfusion parameters measured by CT perfusion software with histologic vascular parameters.Materials and methods: CTPI was performed in thirty-three patients with HCC and twenty-eight control subjects. Hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP), total liver perfusion (TLP), hepatic arterial perfusion index (HAPI) and hepatic portal perfusion index (HPPI) were calculated by maximum slope method. The paraffin-embedded tumor specimens of nineteen patients who underwent surgical excision were stained with vascular endothelial growth factor (VEGF) and CD31 using immunohistochemical method. VEGF staining was evaluated by percentage of positive tumor cells. CD31 staining was expressed as MVD per high power field at 400×magnification.Results: The HAP and HAPI values in patients with HCC were significantly higher than those in the control group (P＜0.05), and HPP, TLP and HPPI values in patients with HCC were markedly lower than those in the control group respectively (P＜0.05). Correlation analysis revealed that the HAP was positively related to the expression of VEGF, and the HAP and TLP significantly correlated with microvessel density (MVD) (P＜0.05), moreover, there was a positive relationship between the expression of VEGF and MVD in HCC (P＜0.05).Conclusions: Perfusion CT can provide quantitative information about arterial and portal perfusion of liver tumors, and this technique has a potential to evaluate the angiogenesis of liver tumors in vivo. PartⅢEvaluation of hemodynamic changes after transcatheter arterial chemoembolization of primary hepatic carcinomas by using multidetector CT perfusion imagingObjective: To evaluate the hemodynamic changes after transcatheter arterial chemoembolization (TACE) of primary hepatic carcinomas (PHC) by using multidetector CT perfusion imaging.Materials and methods: Twenty seven patients with PHC underwent CT perfusion imaging one week before and one month after TACE. Hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP), total liver perfusion (TLP), hepatic arterial perfusion index (HAPI) and hepatic portal perfusion index (HPPI) were measured by using a functional CT software program.Results: With the exception of HPP and TLP, HAP and HAPI of the liver tumors decreased significantly respectively (P＜0.05), however, HPPI increased remarkably (P＜0.05) after successful TACE.Conclusions: The results of this study validate the use of CT perfusion imaging in the evaluation of the hemodynamic changes after TACE for PHC, and this technique has a potential to monitor the therapeutic response in vivo.