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Low contrast medium and radiation dose for hepatic computed tomography perfusion of rabbit VX2 tumor

World Journal of Gastroenterology 2015年第17期21卷 5259-5270页

作者： Cai-Yuan Zhang Yan-Fen Cui Chen Guo Jing Cai Ya-Fang Weng Li-Jun Wang Deng-Bin Wang Department of Radiology Xinhua HospitalShanghai Jiao Tong University School of Medicine

AIM:To evaluate the feasibility of low contrast medium and radiation dose for hepatic computed tomography(CT) perfusion of rabbit VX2 tumor.METHODS:Eleven rabbits with hepatic VX2 tumor underwent perfusion CT scanning with a 24-h interval between a conventional tube potential(120 k Vp) protocol with 350 mg I/m L contrast medium and filtered back projection,and a low tube potential(80 k Vp) protocol with 270 mg I/m L contrast medium with iterative reconstruction.Correlation and agreement among perfusion parameters acquired by the conventional and low dose protocols were assessed for the viable tumor component as well as whole tumor.Image noise and tumor-to-liver contrast to noise ratio during arterial and portal venous phases were evaluated.RESULTS:A 38% reduction in contrast medium dose(360.1 ± 13.3 mg I/kg vs 583.5 ± 21.5 mg I/kg,P perfusion(r = 0.907,P perfusion(r = 0.819,P = 0.002;r = 0.831,P = 0.002),and hepatic blood flow(r = 0.945,P perfusion index(r = 0.736,P = 0.01;r = 0.636,P = 0.035) between the low dose protocol with iterative reconstruction and the conventional protocol for the viable tumor component and the whole tumor.These two imaging protocols provided a moderate but acceptable agreement for perfusion parameters and similar tumorto-liver CNR during arterial and portal venous phases(5.63 ± 2.38 vs 6.16 ± 2.60,P = 0.814;4.60 ± 1.27 vs 5.11 ± 1.74,P = 0.587).CONCLUSION:Compared with the conventional protocol,low contrast medium and radiation dose with iterative reconstruction has no significant influence on hepatic perfusion parameters for rabbits VX2 tumor.

关键词： Low radiation dose Low concentrationcontrast medium perfusion computed tomography Liver VX2 tumor

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Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol

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World Journal of Gastroenterology 2015年第32期21卷 9544-9553页

作者： Lei Wang Fu-Liang He Fu-Quan Liu Zhen-Dong Yue Hong-Wei Zhao Department of Interventional Therapy Beijing Shijitan Hospital Capital Medical University

AIM: To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol.METHODS: Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 m L of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 m L of saline, respectively. Hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery. RESULTS: In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portalsystemic bypass circulation nor death occurred. In experimental group 3, two animals died and threeanimals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation. CONCLUSION: It is feasible to establish an animal model of hepatic cirrhosis and portal hyperten

关键词： Alcohol Hepatic arterial perfusion Hepatic cirrhos

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Intraperitoneal perfusion of cytokine-induced killer cells with local hyperthermia for advanced hepatocellular carcinoma

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World Journal of Gastroenterology 2013年第19期19卷 2956-2962页

作者： Xiao-Pu Wang Meng Xu Hong-Fei Gao Jian-Fu Zhao Ke-Cheng Xu Department of Oncology The First Affiliated Hospital of Jinan University Department of Oncology Clifford HospitalGuangzhou University of Chinese Medicine Department of Oncology the First Affiliated Hospital of Jinan University Fuda Cancer Hospital Jinan University

AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients.

关键词： Cytokine-induced killer cell Radio frequency hyperthermia Primary hepatocellular carcinoma Intraperitoneal perfusion Clinical observation

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Intestinal injury can be reduced by intra-arterial postischemic perfusion with hypertonic saline

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World Journal of Gastroenterology 2013年第2期19卷 209-218页

作者： Oleg Kornyushin Michael Galagudza Anna Kotslova Gelfia Nutfullina Nina Shved Alexey Nevorotin Valeriy Sedov Timur Vlasov Department of Surgery I.P.Pavlov Federal Medical University197022 St.PetersburgRussia Department of Pathophysiology I.P.Pavlov Federal Medical University197022 St.PetersburgRussia Institute of Experimental Medicine V.A.Almazov Federal HeartBlood and Endocrinology Centre197341 St.PetersburgRussia Department of Pathology I.P.Pavlov Federal Medical University197022 St.PetersburgRussia Laboratory of Electron Microscopy I.P.Pavlov Federal Medical University197022 St.PetersburgRussia

AIM:To investigate the effect of local intestinal perfusion with hypertonic saline(HTS) on intestinal ischemia-reperfusion injury(IRI) in bothex vivo andin vivo rat models.METHODS:All experiments were performed on male Wistar rats anesthetized with pentobarbital sodium given intraperitoneally at a dose of 60 mg/kg.Ex vivo vascularly perfused rat intestine was subjected to 60-min ischemia and either 30-min reperfusion with isotonic buffer(controls),or 5 min with HTS of 365 or 415 mOsm/L osmolarity(HTS 365mOsm or HTS 415mOsm,respectively) followed by 25-min reperfusion with isotonic buffer.The vascular intestinal perfusate flow(IPF) rate was determined by collection of the effluent from the portal vein in a calibrated tube.Spontaneous intestinal contraction rate was monitored throughout.Irreversible intestinal injury or area of necrosis(AN) was evaluated histochemically using 2.3.5-triphenyltetrazolium chloride staining.In vivo,30-min ischemia was followed by either 30-min blood perfusion or 5-min reperfusion with HTS 365mOsm through the superior mesenteric artery(SMA) followed by 25-min blood perfusion.Arterial blood pressure(BP) was measured in the common carotid artery using a miniature pressure transducer.Histological injury was evaluated in both preparations using the Chui score.RESULTS:Ex vivo,intestinal IRI resulted in a reduction in the IPF rate during reperfusion(P perfusion in the control group as compared to the sham-treated group,but no such increase was seen in the HTS 365mOsm group.In controls,AN averaged 14.8% ± 5.07% of the total tissue volume.Administration of HTS 365mOsm for 5 min after 60-min ischemia resulted in decrease in

关键词： Intestinal ischemia-reperfusion injury Superior mesenteric artery perfusion Hypertonic saline Acute mesenteric ischemia Intestinal perfusate flow rate

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Quantification of angiogenesis by CT perfusion imaging in liver tumor of rabbit

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Hepatobiliary & Pancreatic Diseases International 2009年第2期8卷 168-173页

作者： Jiang, Hui-Jie Zhang, Zai-Ren Shen, Bao-Zhong Wan, Yong Guo, Hong Li, Jin-Ping Harbin Med Coll Affiliated Hosp 4 Dept Med Imaging Harbin 150001 Peoples R China Harbin Med Coll Affiliated Hosp 2 Harbin 150086 Peoples R China

BACKGROUND:Tumor angiogenesis is essential for primary and metastatic tumor growth.Computed tomography perfusion(CTP)is a new imaging method,made possible by the recent development of fast CT scanners and improved data analysis techniques,which allows measurement of the physiologic and hemodynamic properties of tissue vasculature.This study aimed to evaluate CTP in the quantification of angiogenesis and to assess the relationship between tissue perfusion parameters and microvascular density(MVD)and vascular endothelial growth factor(VEGF),attempting to detect the physiologic properties of angiogenesis.METHODS:Sixteen rabbits with VX2 liver tumors underwent multi-slice CT perfusion(MSCTP)on day 14 after tumor inoculation.CTP parameters included hepatic blood flow(HBF),hepatic blood volume(HBV),mean transit time(MTT),permeability of capillary vessel surface(PS),hepatic artery index(HAI),hepatic artery perfusion(HAP),and hepatic portal perfusion(HPP).The border of the tumor was stained with CD34 and VEGF immunohistochemical stains,and MVD was measured by anti-CD34.Then,CTP parameters were determined whether they were correlated with MVD and VEGF using Pearson’s correlation coefficient.RESULTS:The positive expression of MVD was different in the center and border of the tumor(Pperfusion parameters and MVD and VEGF in the border of the tumor.HBF,PS,HAI,and HAP values were positively correlated with MVD and VEGF(P0.05).CONCLUSIONS:Significant correlations were found between perfusion parameters and MVD and VEGF.Therefore,MSCTP can be used to evaluate tumor angiogenesis in vivo.

关键词： liver neoplasms angiogenesis immunohistochemistry perfusion imaging animal model

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World Journal of Clinical Cases 2023年第5期11卷 1031-1039页

作者： Fahri Aydin Mecit Kantarci Sonay Aydın Erdal Karavaş Gökhan Ceyhun Hayri Ogul ÇağrıEminŞahin Suat Eren Department of Radiology Ataturk UniversityErzurum 25000Turkey Department of Radiology Erzincan Binali Yidirim UniversityErzincan 24000Turkey Department of Radiology Bandirma Onyedi Eylul UniversityBalikesir 10200Turkey Department of Cardiology Ataturk UniversityErzurum 25000Turkey General Directorate of Public Health Ministry of Health in TürkiyeAnkara 06100Turkey

BACKGROUND No study on dual energy computed tomography(DECT)has been found in the literature to evaluate possibly fatal cardiac/myocardial problems in corona virus disease 2019(COVID-19)patients.Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion,and these deficits can be shown via DECT with a perfect interrater agreement.AIM To assess lung perfusion alterations in COVID-19 patients.To our knowledge,no study using DECT has been performed to evaluate possibly fatal cardiac/myocardial problems in COVID-19 patients.The purpose of this study is to evaluate the role of DECT in the detection of COVID-19-related cardiac diseases.METHODS Two blinded independent examiners evaluated CT images using the 17-segment model according to the American Heart Association’s classification of the segmentation of the left ventricular myocardium.Additionally,intraluminal diseases and abnormalities in the main coronary arteries and branches were investigated.Following segment-by-segment analysis,perfusion deficiencies identified on the iodine map pictures on DECT were identified.RESULTS The study enrolled a total of 87 patients.Forty-two of these individuals were classified as COVID-19 positive,and 45 were classified as controls.perfusion deficits were identified in 66.6%(n=30)of the cases.All control patients had a normal iodine distribution map.perfusion deficits were found on DECT iodine map images with subepicardial(n=12,40%),intramyocardial(n=8,26.6%),or transmural(n=10,33.3%)anatomical locations within the left ventricular wall.There was no subendocardial involvement in any of the patients.CONCLUSION Myocardial perfusion deficits can be found in COVID-19 patients even without any significant coronary artery occlusion.These deficits can be shown via DECT with a perfect interrater agreement.Additionally,the presence of perfusion deficit is positively correlated with D-dimer levels.

关键词： Dual energy computed tomography COVID-19 Heart perfusion D-dimer

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Positron emission tomography to assess hypoxia and perfusion in lung cancer

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World Journal of Clinical Oncology 2014年第5期5卷 824-844页

作者： Eline E Verwer Ronald Boellaard Astrid AM van der Veldt Department of Radiologyand Nuclear Medicine VU University Medical Center 1007 MBAmsterdam The Netherlands Department of Internal Medicine VUUniversity Medical Center 1007 MB Amsterdam The Netherlands

In lung cancer, tumor hypoxia is a characteristic feature, which is associated with a poor prognosis and resistance to both radiation therapy and chemotherapy. As the development of tumor hypoxia is associated with decreased perfusion, perfusion measurements provide more insight into the relation between hypoxia and perfusion in malignant tumors. Positron emission tomography(PET) is a highly sensitive nuclear imaging technique that is suited for non-invasive in vivo monitoring of dynamic processes including hypoxia and its associated parameter perfusion. The PET technique enables quantitative assessment of hypoxia and perfusion in tumors. To this end, consecutive PET scans can be performed in one scan session. Using different hypoxia tracers, PET imaging may provide insight into the prognostic significance of hypoxia and perfusion in lung cancer. In addition, PET studies may play an important role in various stages of personalized medicine, as these may help to select patients for specifictreatments including radiation therapy, hypoxia modifying therapies, and antiangiogenic strategies. In addition, specific PET tracers can be applied for monitoring therapy. The present review provides an overview of the clinical applications of PET to measure hypoxia and perfusion in lung cancer. Available PET tracers and their characteristics as well as the applications of combined hypoxia and perfusion PET imaging are discussed.

关键词： Molecular imaging Positron emission tomography Hypoxia perfusion Quantification Lung cancer

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Magnetic Resonance perfusion in Brain Tumors: Comparison of Different Evaluation Approaches in Dual-Echo and Multi-Echo Techniques

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International Journal of Medical Physics, Clinical Engineering and Radiation Oncology 2017年第2期6卷 174-192页

作者： Volker Hietschold Andrij Abramyuk Tareq Juratli Kerim Hakan Sitoci-Ficici Michael Laniado Jennifer Linn Radiology University Hospital Carl Gustav Carus Dresden Germany Neuroradiology University Hospital Carl Gustav Carus Dresden Germany Neurosurgery University Hospital Carl Gustav Carus Dresden Germany

Dynamic measurements of T1 shortening (dynamic contrast enhanced—DCE) as well as of T2*shortening (dynamic susceptibility contrast—DSC) as two separate measurement strategies are widely used to quantitatively describe tumor perfusion and vascularity. Dual-echo approaches allow for the simultaneous assessment of both effects. The extension to multi-echo sequences should inhere the advantage of improved signal-to-noise ratios and more precise sampling of the T2*decay. The aim of our study is to investigate, if an extension of the dual-echo approach to the multi-echo approach allows for more stable quantitative determination of pharmacokinetic parameters in brain tumors. This study applies a multi-echo approach to obtain different estimations of a vascular input function and analyzes various combinations of vascular input functions and pharmacokinetic models. perfusion measurements were performed with 52 consecutive patients with different brain tumors using a 10-echo gradient echo sequence. Our findings show that the extension to multi-echo sequences leads to an 11%-improvement of the Contrast-to-Noise ratio. Compared to other combinations, an application of Extended Tofts model using the T2*-related venous output function or an output function estimated in the tumor tissue enables the most reliable determination of perfusion parameters, reducing the reproducibility range by a factor of 1.2 to 10 for Ktrans and of 1.2 to 5.5 in the case of rBV calculation. Determination of Ktrans within repeated measurements within about 3 days results as most stable, if AIF from tumor pixels is used as vascular input function, meaning that the scatter is reduced by a factor of 1.2 compared to the next best VIF and by a factor of 10 compared to the worst of the tested approaches. In addition, this study shows that signal decomposition into two components with different Larmor frequencies might provide additional information conc

关键词： MRI Brain Tumors perfusion

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Usefulness of an Anisotropic Diffusion Method in Cerebral CT perfusion Study Using Multi-Detector Row CT

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Open Journal of Medical Imaging 2015年第3期5卷 106-116页

作者： Kenya Murase Takafumi Nanjo Yoshifumi Sugawara Masaaki Hirata Teruhito Mochizuki Department of Medical Physics and Engineering Division of Medical Technology and Science Faculty of Health Science Graduate School of Medicine Osaka University Osaka Japan Department of Radiology Graduate School of Medicine Ehime University Ehime Japan

Purpose: To present an application of the anisotropic diffusion (AD) method to improve the accuracy of the functional images of perfusion parameters such as cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) generated from cerebral CT perfusion studies using multi-detector row CT (MDCT). Materials and Methods: Continuous scans (1 sec/rotation ×60 sec) consisting of four 5-mm-thick contiguous slices were acquired after an intravenous injection of iodinated contrast material in 6 patients with cerebrovascular disease using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. New image data were generated by thinning out the above original images at an interval of 2 sec or 3 sec. The thinned-out images were then interpolated by linear interpolation to generate the same number of images as originally acquired. The CBF, CBV and MTT images were generated using deconvolution analysis based on singular value decomposition. Results: When using the AD method, the correlation coefficient between the MTT values obtained from the original and thinned-out images was significantly improved. Furthermore, the coefficients of variation of the CBF, CBV and MTT values in the white matter significantly decreased as compared to not using the AD method. Conclusion: Our results suggest that the AD method is useful for improving the accuracy of the functional images of perfusion parameters and for reducing radiation exposure in cerebral CT perfusion studies using MDCT.

关键词： Anisotropic Diffusion Method Cerebral CT perfusion Study Multi-Detector Row CT Radiation Exposure

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The Usefulness of Ryusei<sup>®</sup>perfusion Balloon for Treating Acute Coronary Syndrome with Vulnerable Plaque

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World Journal of Cardiovascular Diseases 2019年第2期9卷 69-80页

作者： Fumitsugu Yoshikawa Tetsu Nakajima Masaharu Hanada Kazuo Hirata Ryuichi Aikawa Kuwana City Medical Center Mie Prefecture Japan JCHO Sakuragaoka Hospital Shizuoka Japan

Background: Intracoronary thrombus followed by a rupture of unstable vulnerable plaque is a well-known cause of acute coronary syndrome (ACS). The no reflow/slow flow phenomenon is sometimes observed during a primary percutaneous coronary intervention (PCI) against ACS. It has already been shown that long inflation using a perfusion balloon (PB) is useful to remediate a coronary perforation. Thus, we investigated the usefulness of a PB for treating ACS. Methods: This study was a retrospective, single-center, observational study. One hundred-seven patients with ACS underwent PCI from January 2015 to December 2017 in our hospital. Fifty patients were treated by PB directly (PB group) and the remaining 57 patients were treated by another conventional balloon (C group). We used the Ryuseiò balloon (Kaneka, Japan) as a PB. The clinical outcome was the incidence of the no reflow or slow flow phenomenon, the incidence of using IABP. Results: One patient in the PB group demonstrated slow flow phenomenon temporarily, and the coronary flow was quickly restored by thromboaspiration. In contrast, nine patients in the C group had occurrences of no reflow/slow flow phenomenon. Although all patients in the C group required stenting, some patients (24%) of the PB group did not require stenting. Conclusion: We found that the use of PB had a favorable effect on the treatment of ACS. Some patients completed PCI without a need for stenting.

关键词： A perfusion Balloon Vulnerable Plaque Acute Coronary Syndrome

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