Quantitative assessment of first-pass perfusion of oesophageal squamous cell carcinoma using 64-section MDCT: initial observation

AIM: To clarify the feasibility of first-pass perfusion computed tomography (CT) using 64-section multidetector CT (MDCT) for tumour microcirculation of oesophageal squamous cell carcinoma, and to determine the threshold value of first-pass perfusion values for the discrimination between the microcirculation of the tumour and normal oesophagus. MATERIALS AND METHODS: Forty-one patients with pathologically confirmed oesophageal squamous cell carcinomas served as the test group, which was subdivided into subgroups according to the pathological grades or the status of lymph node metastasis. Forty patients with a normal oesophagus served as controls. At( patients underwent volume-based perfusion imaging using 64-section MDCT. Perfusion parameters including perfusion (PF), peak enhancement (PE), blood volume (BV), and time to peak (TTP) were measured. The differences in perfusion parameters between the test and control groups, and between the subgroups were compared statistically. The cutoff values were obtained statistically to discriminate microcirculation between the tumour and normal oesophagus. RESULTS: Mean values for the BV and TTP of the tumour were 12.57 +/- 5.15 ml/100 g (range 2.9-25.6) and 33.71 +/- 14.12 s (range 6-65), respectively. Mean values for the BV and TTP of the normal oesophagus were 4.33 +/- 3.6 ml/100 g (range 0.3-11.7) and 24.15 +/- 11.67 s (range 6-48), respectively. The BV and TTP were statistically higher in the test group than in the control group (p < 0.05), but no statistical differences in the PF and PE were found between the test and control groups (p > 0.05). There were no statistical differences in all parameters between the subgroups of pathological grades, and between subgroups with and without lymph-node metastases (p > 0.05). For the discrimination of microcirculation of the tumour from that of the normal oesophagus, a threshold BV value of 6.65 ml/100 g was determined and achieved a sensitivity of 95. 1%, and specificity of 90%. CONCLUSION: The first-pass perfusion technique using 64-section MDCT could be valuable to assess the microcirculation of oesophageal squamous cell carcinomas. (C) 2008 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.