Computed Tomography Perfusion Analysis of Pancreatic Carcinoma

Objective: The purpose of this study was to evaluate CT perfusion of pancreatic carcinomas using the Patlak model for assessing perfusion, permeability, and blood volume. Methods: A total of 25 patients with pancreatic carcinoma were examined prospectively with a 64-slice computed tomography (CT) using a dynamic sequence after intravenous injection of 80-mL contrast material (370 mg/mL; flow rate, 5 mL/s). Eighty-kilovolt (peak) perfusion acquisitions were evaluated for estimating perfusion parameters for carcinoma and healthy tissue using a 2-compartment model (Patlak model). Results: Twenty patients had hypodense tumors; in 5 patients, the tumor could not be delineated in contrast-enhanced CT. All carcinomas could be identified clearly in the color-coded perfusion maps. Perfusion, permeability, and blood volume values were significant lower in pancreatic carcinomas compared to healthy pancreatic tissue (0.27 +/- 0.20 vs 0.89 +/- 0.19 min(-1), P < 0.0001; 0.43 +/- 0.20 vs 0.75 +/- 0.16 x 0.5 min(-1), P < 0.0001; and 38.9 +/- 20.7 vs 117.8 +/- 46.9 mL/100 mL, P < 0.0001). Conclusion: Computed tomographic perfusion of the pancreas using a 2-compartment perfusion model is feasible. Color-coded perfusion maps could be a helpful tool to delineate pancreatic carcinomas even if they are not visible in contrast-enhanced CT.