Multi-detector CT perfusion as a diagnostic imaging modality to evaluate local therapy of hepatocellular carcinoma

ObjectiveTo evaluate MDCT perfusion role in HCC local therapy response.Patients and methodsPost radiofrequency ablation and trans-arterial chemoembolization 14 (88%) male and 2 (12%) female HCC patients; with the mean age, 55.75 ± 10.6 years underwent follow-up hepatic CT perfusion. The hepatic arterial and portal venous perfusions (HAP and HPP, ml/min/100 ml) and hepatic perfusion index (HPI%) were indicated using the color coded maps to assess the effects of local therapy on hepatic perfusion values.ResultsThe post local treatment CTP of the recurrent tumor confirmed relative increased HAP and HPI and reduced PVP relative to the background values of the cirrhotic hepatic parenchyma. The recurrent HCC post-treatment CTP including HAP is 71 ± 12.19, the PVP is 25.5 ± 8.66 and HPI is 52.5 ± 11.9. The post local-treatment CTP of the necrosis confirmed relative decreased HAP and HPI and increased PVP. The post-treatment necrosis CTP including HAP is 23 ± 10.39, the PVP is 34.75 ± 11.5 and HPI is 29 ± 16.51. The CTP sensitivity is 75%, specificity 50% and P-value <0.05.ConclusionCTP is a promising non-invasive technique assessing the efficacy, predicting early response to local treatment therapies and monitoring tumor recurrence. It assesses the degree of post therapy tumor perfusion especially the degree of arterialization.