Relationship between CT volumetric measurements and Doppler perfusion indices in gastrointestinal liver metastasis

• Published in: Radiologia medica Vol. 120; no. 2; pp. 171 - 179
• Main Authors: Radmard, Amir Reza, Abrishami, Alireza, Gholamrezanezhad, Ali, Kolahdoozan, Shadi, Sedighi, Nahid, Taheri, Amir Pejman Hashemi
• Format: Journal Article
• Language: English
• Published: Milan Springer Milan 01.02.2015
• Subjects: Abdominal Radiology; Adult; Aged; Aged, 80 and over; Cone-Beam Computed Tomography; Diagnostic Radiology; Female; Gastrointestinal Neoplasms - pathology; Hemodynamics; Humans; Imaging; Interventional Radiology; Liver Neoplasms - blood supply; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - secondary; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroradiology; Radiology; Regional Blood Flow; Ultrasonography, Doppler; Ultrasound; Doppler perfusion index; CT volumetric measurement; Liver metastasis; Liver hemodynamics
• ISSN: 0033-8362; 1826-6983; 1826-6983
• DOI: 10.1007/s11547-014-0423-y

Purpose This study investigated how the volume of hepatic metastatic lesions can affect liver haemodynamics and whether these perfusion parameters may help to differentiate benign and malignant liver lesions. Materials and methods The Doppler perfusion index (DPI the ratio of arterial to total liver blood flow) was measured in 46 patients aged 29–83 years, exhibiting up to four focal hyperechoic liver lesions at ultrasound examination. They comprised histopathologically proven liver metastasis of colorectal (19 cases) and gastric (10 cases) adenocarcinoma without local recurrence at the site of the previously resected primary tumour, along with 17 subjects with haemangioma. All patients underwent volumetric assessment using multislice computed tomography to calculate total volume of hepatic lesions. Results The mean DPI of patients with colorectal (36 ± 2 %) and gastric (39 ± 6 %) metastasis was significantly higher than those with haemangioma (14 ± 2 %) (both p  < 0.001), whereas metastatic groups did not exhibit any difference in terms of mean DPI. Statistically significant correlations were found between DPI values and calculated total volume of lesions in patients with colorectal and gastric metastasis ( r  = 0.55, p  = 0.01 and r  = 0.85, p  = 0.002, respectively) while this correlation was not demonstrated in the haemangioma group. Simple linear regression analysis revealed that every 1 cm 3 increment in total volume of metastatic lesions increased DPI by 0.2 % [95 % confidence interval (CI) 0.1–0.3, p  = 0.001]. Conclusion Doppler perfusion index alterations are directly correlated with total volume of metastatic deposits, and DPI measurement can be a valuable method to distinguish haemangioma from hyperechoic colorectal and gastric metastatic lesions.