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Dynamic Contrast Enhanced Computed Tomography Measurement of Perfusion in Hepatic Cancer.

机译：动态对比增强计算机断层扫描在肝癌灌注中的测量。

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摘要

In recent years, the incidence and mortality rate for hepatocellular carcinoma (HCC) have increased due to the emergence of hepatitis B, C and other diseases that cause cirrhosis. The progression from cirrhosis to HCC is characterized by abnormal vascularization and by a shift from a venous to an arterial blood supply. A knowledge of HCC vascularity which is manifested as alterations in liver blood flow may distinguish among different stages ofliver disease and can be used to monitor response to treatment. Unfortunately, conventional diagnostic imaging techniques lack the ability to accurately quantify HCC vascularity. The purpose of this thesis was to validate and assess the diagnostic capabilities of dynamic contrast enhanced computed tomography (DCE-CT) and perfusion software designed to measure hepatic perfusion.;In Chapter 3, we used fluorine-I 8 fluoro-2-deoxy-D-glucose (FDG) positron emission tomography and DCE-CT perfusion to determined an inverse correlation between glucose utilization and tumor blood flow; with an R2 of 0.727 (P 0.05). This suggests a limited supply ofoxygen (possibly hypoxia) and that the tumor cells were surviving via anaerobic glycolysis.;In Chapter 4, hepatic perfusion data showed that thalidomide caused a reduction of tumor perfusion in the responder group during the first 8 days after therapy, P 0.05; while perfusion in the partial responder and control group remained unchanged, P > 0.05. These changes were attributed to vascular remodeling and maturation resulting in a more functional network of endothelial tubes lined with pericytes.;The results of this thesis demonstrate the accuracy and precision of DCE-CT hepatic perfusion measurements. It also showed that DCE-CT perfusion has the potential to enhance the functional imaging ability of hybrid PET/CT scanners and evaluate the efficacy of anti-angiogenesis therapy.;Chapter 2 described a study designed to evaluate the accuracy and precision of hepatic perfusion measurement. The results showed a strong correlation between hepatic artery blood flow measurement with DCE-CT and radioactive microspheres under steady state in a rabbit model for HCC (VX2 carcinoma). Using repeated measurements and Monte Carlo simulations, DCE-CT perfusion measurements were found to be precise; with the highest precision in the tumor rim.;Keywords: Hepatocellular carcinoma, hepatic blood flow, angiogenesis, thalidomide, dynamic contrast enhanced computed tomography, positron emission tomography, fluorine-18 fluoro-2-deoxy-D-glucose, imaging, CT Perfusion
机译：近年来，由于乙型，丙型肝炎和其他引起肝硬化的疾病的出现，肝细胞癌（HCC）的发病率和死亡率增加。从肝硬化到肝癌的发展特征在于异常的血管形成和从静脉血供转向动脉血供。表现为肝血流改变的HCC血管知识可以区分肝脏疾病的不同阶段，并可用于监测对治疗的反应。不幸的是，传统的诊断成像技术缺乏准确量化HCC血管的能力。本文的目的是验证和评估动态对比增强计算机断层扫描（DCE-CT）和旨在测量肝脏灌注的灌注软件的诊断能力。在第三章中，我们使用了氟-I 8氟-2-脱氧- D-葡萄糖（FDG）正电子发射断层扫描和DCE-CT灌注确定葡萄糖利用与肿瘤血流之间的反相关关系； R2为0.727（P <0.05）。这表明氧气供应有限（可能是缺氧），并且肿瘤细胞通过厌氧糖酵解得以存活。;在第4章中，肝灌注数据显示，沙利度胺在治疗后的前8天导致响应者组的肿瘤灌注减少， P <0.05；部分反应者和对照组的灌注保持不变，P> 0.05。这些变化归因于血管重塑和成熟，从而使内衬周细胞的内皮管网络更加功能化。；本文的结果证明了DCE-CT肝灌注测量的准确性和准确性。这也表明DCE-CT灌注有可能增强混合PET / CT扫描仪的功能成像能力并评估抗血管生成疗法的有效性。;第二章介绍了一项旨在评估肝灌注测量准确性和准确性的研究。 。结果显示，在兔肝癌（VX2癌）模型中，DCE-CT进行的肝动脉血流量测量与稳态下的放射性微球之间存在强相关性。使用重复测量和蒙特卡洛模拟，发现DCE-CT灌注测量是精确的。关键词：肝细胞癌，肝血流，血管生成，沙利度胺，动态对比增强计算机断层扫描，正电子发射断层扫描，氟-18氟-2-脱氧-D-葡萄糖，成像，CT灌注

著录项

  • 作者

    Stewart, Errol E.;

  • 作者单位

    The University of Western Ontario (Canada).;

  • 授予单位 The University of Western Ontario (Canada).;
  • 学科 Health Sciences Radiology.;Biophysics Medical.;Health Sciences Health Care Management.
  • 学位 Ph.D.
  • 年度 2010
  • 页码 183 p.
  • 总页数 183
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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