Search

Rationale and Objectives The goal was to improve informativeness in the determination of liver perfusion with a clinically available iodinated computed tomography (CT) contrast agent by developing open multicompartmental modeling. Materials and Methods Contrast-enhanced functional CT (fCT) examinations were conducted with temporal resolutions of 200–500 msec to 6 New Zealand White rabbits. First, we applied conventional open two-compartment model for the determination of arterial and portal blood flows (F A and F P ), blood and interstitial volume fractions (f b and f i ), and capillary permeability–surface area product (PS) of liver parenchyma. Then, we improved the modeling of vascular physiology by developing three- and open four-compartment models. For comparison, conventional single-compartment model was applied. We determined F A and F P also by using the peak-gradient method. Results Conventional two-compartment model yielded identical fittings with single-compartment model and does not provide unique solutions for f b and f i . The presented open four-compartment model provided F A and F P values of 0.40 ± 0.19 and 1.99 ± 0.57 mL/min/mL (tissue), f b and f i values of 0.30 ± 0.05 and 0.19 ± 0.04 mL/mL (tissue), and PS values of 4.0 ± 1.7 mL/min/mL (tissue). F A and F P are in a good agreement with those derived by using the peak-gradient method. Conclusions With the use of clinical extracellular iodinated CT contrast agent, the presented open four-compartment model provided physiological arterial and portal blood flow values and is also a potential tool in the assessment of blood and interstitial volume fractions and capillary permeability–surface area product. Moreover, the model requires neither measurements from hepatic vein or from other organs nor visual determination of arterial or portal phase.

Rationale and Objectives. To evaluate liver and liver tumor perfusions by using two different modelling methods: gamma-variate fitting and a single-compartment model. Materials and Methods. 5 New Zealand White rabbits with VX2 tumor implanted into the liver via portal injections were studied. Contrast-enhanced functional CT (fCT) examinations with temporal resolution of 200–500 milliseconds were conducted before tumor inoculation. Thereafter, two or three follow-up studies were conducted. A gamma-variate fitting method was used to determine fractional blood volumes (BV), and a single-compartment model method was used to determine fractional blood volumes (BV), blood flows (BF), and mean transit times (MTT) for normal and tumorous liver regions. Results. For tumorous regions in liver, the gamma-variate fitting and the single-compartment model methods showed statistically significant increases in arterial perfusions (P < 0.01) and decreases in portal perfusions (P < 0.01 with single-compartment model, and P < 0.05 with gamma-variate fitting) when compared with normal liver regions. The single-compartment model showed statistically significant increases (P < 0.01) in MTTs in tumorous regions. In normal liver regions, portal BFs decreased and MTTs increased after tumor inoculation, but the changes were statistically not significant. Conclusion. The gamma-variate fitting and the single-compartment model methods showed definite differences in perfusions between normal and tumorous regions in liver. The single-compartment model showed slightly more distinction and was faster. More importantly, both methods can easily be applied in the clinical environment in the assessment of liver perfusion.

Rationale and Objectives To compare liver perfusion parameters obtained by using an extravascular contrast agent and a blood-pool agent. Materials and Methods Fifteen rabbits were imaged with a continuous 40-second single-slice computed tomography acquisition after a bolus injection of contrast agent (physiologic bolus duration 4–5 seconds, extravascular iohexol, n = 7; experimental nanoparticulated blood-pool agent WIN8883, n = 8). Time-density curves were generated for the aorta, portal vein, and liver. From the curves, arterial, portal, and total blood flows and hepatic perfusion index (HPI, arterial-to-total perfusion ratio) were determined by using two commonly applied fundamentally different analyzing methods: the single-compartment model and the peak gradient (PG) method. Also, the gamma variate fitting method was used. Results By using the single-compartment model, the obtained HPI and total blood flow were 0.14 ± 0.04 and 2.29 ± 0.40 (mL/min/mLtissue) for WIN8883, and 0.15 ± 0.06 (P = .54) and 4.60 ± 1.14 (mL/min/mLtissue) (P = .0002) for iohexol, respectively. With the PG, HPI and total blood flow were 0.15 ± 0.08 and 1.27 ± 0.24 (mL/min/mLtissue) for WIN8883, and 0.20 ± 0.06 (P = .12) and 2.11 ± 0.25 (mL/min/mLtissue) (P = .00002) for iohexol, respectively. With the blood pool agent, similar contrast enhancement to the conventional agent was achieved with about 36% reduced dosage of iodine per body weight (mg I/kg). Conclusions HPI was found to be quite insensitive to different contrast agent types and analyzing methods. However, the arterial, portal and total liver blood flow values strongly depend on contrast agent type and modeling method.