Computed Tomography Perfusion Analysis of Pancreatic Carcinoma

Abstract

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 × 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.