Early Detection of Local RFA Site Recurrence Using Total Liver Volume Perfusion CT: Initial Experience

Meijerink, Martijn R.; van Waesberghe, Jan Hein T.M.; van der Weide, Lineke; van den Tol, Petrousjka; Meijer, Sybren; Comans, Emile F.; Golding, Richard P.; van Kuijk, Cornelis

doi:10.1016/j.acra.2009.03.023

« Previous Next »Academic Radiology
Volume 16, Issue 10 , Pages 1215-1222, October 2009

Early Detection of Local RFA Site Recurrence Using Total Liver Volume Perfusion CT:

Initial Experience

Martijn R. Meijerink, MD
- Department of Radiology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
- Address correspondence to: M.R.M.
Jan Hein T.M. van Waesberghe, MD, PhD
- Department of Radiology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Lineke van der Weide, BSc
- Master of Oncology Program, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Petrousjka van den Tol, MD, PhD
- Department of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Sybren Meijer, MD, PhD
- Department of Surgical Oncology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Emile F. Comans, MD, PhD
- Department of Nuclear Medicine & PET Research, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Richard P. Golding, MD
- Department of Radiology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands
Cornelis van Kuijk, MD, PhD
- Department of Radiology, VU University Medical Center, De Boelelaan 1117, Postbus 7057 Amsterdam, The Netherlands

Received 29 October 2008; accepted 30 March 2009. published online 15 June 2009.

Rationale and Objectives

The aim of this study was to prospectively evaluate the feasibility of a novel total liver volume perfusion computed tomographic technique in demonstrating treatment-site recurrence of liver metastases after radiofrequency ablation (RFA).

Materials and Methods

Eleven patients considered to be at increased risk for local RFA-site tumor recurrence underwent both positron emission tomography (PET) and perfusion computed tomography (CTP): a 12-phase scan of the entire liver acquired before and 11 times after contrast injection. After coregistration, blood flow maps were created using the maximum slope method.

Results

In all cases, the CTP-derived blood flow maps fully paralleled the PET images in showing either the absence (nine of 13 lesions) or presence (four of 13 lesions) of local RFA-site recurrence. Marginal lesions with high hepatic arterial perfusion (>50 mL/min/100 g) and low portal venous perfusion (<10 mL/min/100 g) represented recurring vital tumor tissue (P < .05).