Hepatic Blood Volume Imaging with the Use of Flat-Detector CT Perfusion in the Angiography Suite: Comparison with Results of Conventional Multislice CT Perfusion

Purpose: To prospectively determine the feasibility of flat-detector (FD) computed tomography (CT) perfusion to measure hepatic blood volume (BV) in the angiography suite in patients with hepatocellular carcinoma (HCC). Materials and Methods: Twenty patients with HCC were investigated with conventional multislice and FD CT perfusion. CT perfusion was carried out on a multislice CT scanner, and FD CT perfusion was performed on a C-arm angiographic system, before transarterial chemoembolization procedures. BY values of conventional and FD CT Perfusion were measured within tumors and liver parenchyma. The arterial perfusion portion of CT perfusion BY was extracted from CT perfusion BY by multiplying it by a hepatic perfusion index. Relative values (RVs) for CT perfusion arterial BY and FD CT perfusion BY (FD BV) were defined by dividing BY of tumor by BY of parenchyma. Relationships between BY and RV values of these two techniques were analyzed. Results: In all patients, both perfusion procedures were technically successful, and all 33 HCCs larger than 10 mm were identified with both imaging methods. There Were strong correlations between the absolute values of FD BY and CT perfusion arterial BY (tumor, r = 0.903; parenchyma, r = 0.920; both P < .001). Bland-Altman analysis showed a mean difference of -0.15 +/- 0.24 between RVs for CT perfusion arterial BY and FD BY. Conclusions: The feasibility of FD CT perfusion to assess BY values of liver tumor and surrounding parenchyma in the angiographic suite was demonstrated.