CRC - Multi-Detector Computed Tomography in Oncology: CT Perfusion Imaging

Organization: CRC
Publication Date: 15 September 2007
Page Count: 260


It is now more than 25 years since Leon Axel proposed a method for determination of cerebral blood flow from rapid-sequence contrastenhanced computed tomography (CT). Today, the availability of rapid imaging with multidetector CT systems and commercial analysis software has made perfusion imaging with CT an everyday technique for clinical practice.

CT remains an essential tool in the assessment of patients with cancer, not only for diagnosis but also for assessment of disease extent and severity, and for the evaluation of response to treatment. Perfusion CT is readily performed as an adjunct to conventional CT, providing valuable information about tumor vascularity. In many ways, perfusion CT is not unlike CT angiography, but depicts the functional status of the tumor circulation at tissue level rather than visualizing the morphology of discrete vessels. By reflecting the processes of tumor angiogenesis, this additional information can aid in diagnosis, assess tumor aggression, and help to overcome some of the limitations associated with morphological criteria for evaluation of tumor response.

The development of perfusion CT also links with another recent advance in cancer imaging, the introduction of integrated positron emission tomography (PET)-CT systems. The increasing use of intravenous contrast material during PET-CT can be extended to include a CT perfusion study. In this way, it is now possible to depict tumor morphology, perfusion, and glucose metabolism to provide an exceptionally detailed assessment of tumor biology in a single examination.

This book is the first to be dedicated solely to the application of perfusion CT in oncology. The aim is to provide the technical knowledge required to reliably obtain CT perfusion images of tumors, to give an understanding of the pathophysiology of tumor angiogenesis and its relationship to contrast enhancement on CT, and to outline the ability of perfusion CT to enhance diagnosis, prognosis, and therapy monitoring for patients with cancer. The technique is also portrayed in its historical context. The book will therefore be of interest to radiologists and radiographers currently using perfusion CT or considering its introduction to their institution. The information will also be valuable to clinicians treating patients with cancer and to researchers involved in the development of new cancer therapies.