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1.
Br J Radiol ; 90(1078): 20170214, 2017 Oct.
Article in English | MEDLINE | ID: mdl-28830195

ABSTRACT

OBJECTIVE: To evaluate the agreement between the measurements of perfusion CT parameters in normal livers by using two different software packages. METHODS: This retrospective study was based on 78 liver perfusion CT examinations acquired for detecting suspected liver metastasis. Patients with any morphological or functional hepatic abnormalities were excluded. The final analysis included 37 patients (59.7 ± 14.9 y). Two readers (1 and 2) independently measured perfusion parameters using different software packages from two major manufacturers (A and B). Arterial perfusion (AP) and portal perfusion (PP) were determined using the dual-input vascular one-compartmental model. Inter-reader agreement for each package and intrareader agreement between both packages were assessed with intraclass correlation coefficients (ICC) and Bland-Altman statistics. RESULTS: Inter-reader agreement was substantial for AP using software A (ICC = 0.82) and B (ICC = 0.85-0.86), fair for PP using software A (ICC = 0.44) and fair to moderate for PP using software B (ICC = 0.56-0.77). Intrareader agreement between software A and B ranged from slight to moderate (ICC = 0.32-0.62) for readers 1 and 2 considering the AP parameters, and from fair to moderate (ICC = 0.40-0.69) for readers 1 and 2 considering the PP parameters. CONCLUSION: At best there was only moderate agreement between both software packages, resulting in some uncertainty and suboptimal reproducibility. Advances in knowledge: Software-dependent factors may contribute to variance in perfusion measurements, demanding further technical improvements. AP measurements seem to be the most reproducible parameter to be adopted when evaluating liver perfusion CT.


Subject(s)
Hemodynamics , Liver/blood supply , Liver/diagnostic imaging , Perfusion Imaging/methods , Software , Tomography, X-Ray Computed , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Observer Variation , Reproducibility of Results , Retrospective Studies , Young Adult
2.
Radiol. bras ; 45(1): 39-45, jan.-fev. 2012. ilus, tab
Article in Portuguese | LILACS | ID: lil-618394

ABSTRACT

Novas técnicas de exames têm sido desenvolvidas com o objetivo de se obter não apenas uma avaliação estrutural, mas também uma análise funcional e metabólica de diversos órgãos e tipos de lesões. Entre estas ferramentas, a perfusão por tomografia computadorizada (PTC) tem despertado o interesse de muitos pesquisadores em estudar a sua aplicabilidade em órgãos e doenças abdominais. Entre estas aplicações podemos citar a avaliação do comportamento biológico de tecidos sadios e doentes, a diferenciação de processos inflamatórios de tumorais e o diagnóstico da recidiva tumoral após terapêuticas minimamente invasivas. A principal característica da PTC reside na sua capacidade de caracterizar comportamentos perfusionais distintos e que traduzem alterações biológicas de determinadas lesões e tecidos doentes. Dessa forma, o nosso objetivo foi realizar uma ampla revisão da literatura, mostrando as principais técnicas e protocolos utilizados nos exames de PTC, as principais indicações, vantagens e desvantagens do método, além de propor um protocolo de exame que possa ser introduzido na rede privada e pública de saúde, com reprodutibilidade e simplicidade de implementação.


New imaging techniques have been developed with the objective of obtaining not only a structural assessment, but also a metabolic and functional analysis of different organs and types of lesions. Among such tools perfusion computed tomography (PCT) has recently aroused the interest of many researchers in studying the applicability of such imaging modality in the evaluation of abdominal organs and diseases. Analysis of the biological behavior of healthy and diseased tissues, differentiation of inflammatory processes from tumors, and diagnosis of tumor recurrence after minimally invasive therapies can be mentioned as applications of such an imaging modality. The main features of PCT are related to its ability to characterize different perfusional behaviors reflecting biological changes of certain lesions and diseased tissues. Thus, the present study was aimed at carrying out a comprehensive literature review, describing the key techniques and protocols utilized in PCT imaging, main clinical applications, advantages and disadvantages of the method, besides proposing an imaging protocol that can be adopted by both private and public health services, with good reproducibility and easy implementation.


Subject(s)
Humans , Abdomen/pathology , Diagnostic Techniques and Procedures , Perfusion Imaging/methods , Reproducibility of Results , Sensitivity and Specificity , Multidetector Computed Tomography , Contrast Media/administration & dosage
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