Research Progress of Low Radiation Dose Computed Tomography Perfusion of the Liver_Journal of Biomedical Engineering

Authors：

ZHAOYijun ,  CHENWeixia

Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

CHENWeixia, Email: wxchen25@126.com

Keywords：

computed tomography perfusion; low radiation dose; liver; iterative reconstruction; automatic tube current modulation

DOI：

10.7507/1001-5515.20160068

Video：

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Liver computed tomography (CT) perfusion is a noninvasive imaging technology which can quantitatively investigate liver function, and it is mainly used in the diagnosis of liver tumors and assessment of liver function in the state of chronic liver diseases. The use of liver CT perfusion was limited in the past because of the high radiation dose. Now new technologies are exploited and they make it possible to reduce the radiation burden while maintaining the imaging quality. This article discusses the research progress of low radiation dose CT perfusion in 3 aspects, including X-ray source, reconstruction algorithm, and improvement of CT scanners and optimization of scanning parameters. Although there are not too many studies of low radiation dose CT perfusion on liver now and many problems need to be solved, the clinical application of it will be very prospective.

Citation： ZHAOYijun, CHENWeixia. Research Progress of Low Radiation Dose Computed Tomography Perfusion of the Liver. Journal of Biomedical Engineering, 2016, 33(2): 400-404. doi: 10.7507/1001-5515.20160068 Copy

1.	GOH V, DATTANI M, FARWELL J, et al. Radiation dose from volumetric helical perfusion CT of the thorax, abdomen or pelvis[J]. Eur Radiol, 2011, 21(5):974-981.
2.	BEGANOVIC A, SEFIC-PASIC I, SKOPLJAK-BEGANOVIC A, et al. Doses to skin during dynamic perfusion computed tomography of the liver[J]. Radiat Prot Dosimetry, 2013, 153(1):106-111.
3.	KANDA T, YOSHIKAWA T, OHNO Y, et al. CT hepatic perfusion measurement:comparison of three analytic methods[J]. Eur J Radiol, 2012, 81(9):2075-2079.
4.	GOETTI R, LESCHKA S, DESBIOLLES L, et al. Quantitative computed tomography liver perfusion imaging using dynamic spiral scanning with variable pitch:feasibility and initial results in patients with cancer metastases[J]. Invest Radiol, 2010, 45(7):419-426.
5.	RONOT M, LAMBERT S, DAIRE J L, et al. Can we justify not doing liver perfusion imaging in 2013?[J]. Diagn Interv Imaging, 2013, 94(12):1323-1336.
6.	VAN BEERS B E, LECONTE I, MATERNE R, et al. Hepatic perfusion parameters in chronic liver disease:dynamic CT measurements correlated with disease severity[J]. AJR Am J Roentgenol, 2001, 176(3):667-673.
7.	OKADA M, KIM T, MURAKAMI T. Hepatocellular nodules in liver cirrhosis:state of the art CT evaluation (perfusion CT/volume helical shuttle scan/dual-energy CT, etc.)[J]. Abdom Imaging, 2011, 36(3):273-281.
8.	MORSBACH F, SAH B R, SPRING L, et al. Perfusion CT best predicts outcome after radioembolization of liver metastases:a comparison of radionuclide and CT imaging techniques[J]. Eur Radiol, 2014, 24(7):1455-1465.
9.	KIM S H, KAMAYA A, WILLMANN J K. CT perfusion of the liver:principles and applications in oncology[J]. Radiology, 2014, 272(2):322-344.
10.	GARCIA-FIGUEIRAS R, GOH V J, PADHANI A R, et al. CT perfusion in oncologic imaging:a useful tool?[J]. AJR Am J Roentgenol, 2013, 200(1):8-19.
11.	HAYANO K, LEE S H, YOSHIDA H, et al. Fractal analysis of CT perfusion images for evaluation of antiangiogenic treatment and survival in hepatocellular carcinoma[J]. Acad Radiol, 2014, 21(5):654-660.
12.	HOANG J K, WANG C, FRUSH D P, et al. Estimation of radiation exposure for brain perfusion CT:standard protocol compared with deviations in protocol[J]. AJR Am J Roentgenol, 2013, 201(5):W730-734.
13.	RAMAN S P, JOHNSON P T, DESHMUKH S, et al. CT dose reduction applications:available tools on the latest generation of CT scanners[J]. J Am Coll Radiol, 2013, 10(1):37-41.
14.	FUJITA M, KITAGAWA K, ITO T, et al. Dose reduction in dynamic CT stress myocardial perfusion imaging:comparison of 80-kV/370-mAs and 100-kV/300-mAs protocols[J]. Eur Radiol, 2014, 24(3):748-755.
15.	LEE K H, LEE J M, MOON S K, et al. Attenuation-based automatic tube voltage selection and tube current modulation for dose reduction at contrast-enhanced liver CT[J]. Radiology, 2012, 265(2):437-447.
16.	SCHWARZ F, GRANDL K, ARNOLDI A, et al. Lowering radiation exposure in CT angiography using automated tube potential selection and optimized iodine delivery rate[J]. AJR Am J Roentgenol, 2013, 200(6):W628-W634.
17.	WATANABE S, KATADA Y, GOHKYU M, et al. Liver perfusion CT during hepatic arteriography for the hepatocellular carcinoma:dose reduction and quantitative evaluation for normal-and ultralow-dose protocol[J]. Eur J Radiol, 2012, 81(12):3993-3997.
18.	KIM S M, KIM Y N, CHOE Y H. Adenosine-stress dynamic myocardial perfusion imaging using 128-slice dual-source CT:optimization of the CT protocol to reduce the radiation dose[J]. Int J Cardiovasc Imaging, 2013, 29(4):875-884.
19.	LIN C J, WU T H, LIN C H, et al. Can iterative reconstruction improve imaging quality for lower radiation CT perfusion? Initial experience[J]. AJNR Am J Neuroradiol, 2013, 34(8):1516-1521.
20.	NIESTEN J M, VAN DER SCHAAF I C, RIORDAN A J, et al. Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction[J]. Eur Radiol, 2014, 24(2):484-493.
21.	XIE Q, WU J, TANG Y, et al. Whole-organ CT perfusion of the pancreas:impact of iterative reconstruction on image quality, perfusion parameters and radiation dose in 256-slice CT-preliminary findings[J]. PLoS One, 2013, 8(11):e80468.
22.	NEGI N, YOSHIKAWA T, OHNO Y, et al. Hepatic CT perfusion measurements:a feasibility study for radiation dose reduction using new image reconstruction method[J]. Eur J Radiol, 2012, 81(11):3048-3054.
23.	SPEIDEL M A, BATEMAN C L, TAO Y, et al. Reduction of image noise in low tube current dynamic CT myocardial perfusion imaging using HYPR processing:a time-attenuation curve analysis[J]. Med Phys, 2013, 40(1):011904.
24.	KANDA T, YOSHIKAWA T, OHNO Y, et al. Perfusion measurement of the whole upper abdomen of patients with and without liver diseases:initial experience with 320-detector row CT[J]. Eur J Radiol, 2012, 81(10):2470-2475.
25.	KAMBADAKONE A R, SHARMA A, CATALANO O A, et al. Protocol modifications for CT perfusion (CTp) examinations of abdomen-pelvic tumors:impact on radiation dose and data processing time[J]. Eur Radiol, 2011, 21(6):1293-1300.
26.	TAWFIK A M, RAZEK A A, ELHAWARY G, et al. Effect of increasing the sampling interval to 2 seconds on the radiation dose and accuracy of CT perfusion of the head and neck[J]. J Comput Assist Tomogr, 2014, 38(3):469-473.
27.	SCHUHBACK A, MARWAN M, GAUSS S, et al. Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography:comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction[J]. Eur Radiol, 2012, 22(7):1529-1536.
28.	HABERLAND U, KLOTZ E, ABOLMAALI N. Performance assessment of dynamic spiral scan modes with variable pitch for quantitative perfusion computed tomography[J]. Invest Radiol, 2010, 45(7):378-386.
29.	姜慧杰, 张在人, 赵雁鸣, 等.肝硬化基础上肝癌肝血流变化功能CT灌注成像研究[J].临床放射学杂志, 2012, 31(5):658-662.

1. GOH V, DATTANI M, FARWELL J, et al. Radiation dose from volumetric helical perfusion CT of the thorax, abdomen or pelvis[J]. Eur Radiol, 2011, 21(5):974-981.
2. BEGANOVIC A, SEFIC-PASIC I, SKOPLJAK-BEGANOVIC A, et al. Doses to skin during dynamic perfusion computed tomography of the liver[J]. Radiat Prot Dosimetry, 2013, 153(1):106-111.
3. KANDA T, YOSHIKAWA T, OHNO Y, et al. CT hepatic perfusion measurement:comparison of three analytic methods[J]. Eur J Radiol, 2012, 81(9):2075-2079.
4. GOETTI R, LESCHKA S, DESBIOLLES L, et al. Quantitative computed tomography liver perfusion imaging using dynamic spiral scanning with variable pitch:feasibility and initial results in patients with cancer metastases[J]. Invest Radiol, 2010, 45(7):419-426.
5. RONOT M, LAMBERT S, DAIRE J L, et al. Can we justify not doing liver perfusion imaging in 2013?[J]. Diagn Interv Imaging, 2013, 94(12):1323-1336.
6. VAN BEERS B E, LECONTE I, MATERNE R, et al. Hepatic perfusion parameters in chronic liver disease:dynamic CT measurements correlated with disease severity[J]. AJR Am J Roentgenol, 2001, 176(3):667-673.
7. OKADA M, KIM T, MURAKAMI T. Hepatocellular nodules in liver cirrhosis:state of the art CT evaluation (perfusion CT/volume helical shuttle scan/dual-energy CT, etc.)[J]. Abdom Imaging, 2011, 36(3):273-281.
8. MORSBACH F, SAH B R, SPRING L, et al. Perfusion CT best predicts outcome after radioembolization of liver metastases:a comparison of radionuclide and CT imaging techniques[J]. Eur Radiol, 2014, 24(7):1455-1465.
9. KIM S H, KAMAYA A, WILLMANN J K. CT perfusion of the liver:principles and applications in oncology[J]. Radiology, 2014, 272(2):322-344.
10. GARCIA-FIGUEIRAS R, GOH V J, PADHANI A R, et al. CT perfusion in oncologic imaging:a useful tool?[J]. AJR Am J Roentgenol, 2013, 200(1):8-19.
11. HAYANO K, LEE S H, YOSHIDA H, et al. Fractal analysis of CT perfusion images for evaluation of antiangiogenic treatment and survival in hepatocellular carcinoma[J]. Acad Radiol, 2014, 21(5):654-660.
12. HOANG J K, WANG C, FRUSH D P, et al. Estimation of radiation exposure for brain perfusion CT:standard protocol compared with deviations in protocol[J]. AJR Am J Roentgenol, 2013, 201(5):W730-734.
13. RAMAN S P, JOHNSON P T, DESHMUKH S, et al. CT dose reduction applications:available tools on the latest generation of CT scanners[J]. J Am Coll Radiol, 2013, 10(1):37-41.
14. FUJITA M, KITAGAWA K, ITO T, et al. Dose reduction in dynamic CT stress myocardial perfusion imaging:comparison of 80-kV/370-mAs and 100-kV/300-mAs protocols[J]. Eur Radiol, 2014, 24(3):748-755.
15. LEE K H, LEE J M, MOON S K, et al. Attenuation-based automatic tube voltage selection and tube current modulation for dose reduction at contrast-enhanced liver CT[J]. Radiology, 2012, 265(2):437-447.
16. SCHWARZ F, GRANDL K, ARNOLDI A, et al. Lowering radiation exposure in CT angiography using automated tube potential selection and optimized iodine delivery rate[J]. AJR Am J Roentgenol, 2013, 200(6):W628-W634.
17. WATANABE S, KATADA Y, GOHKYU M, et al. Liver perfusion CT during hepatic arteriography for the hepatocellular carcinoma:dose reduction and quantitative evaluation for normal-and ultralow-dose protocol[J]. Eur J Radiol, 2012, 81(12):3993-3997.
18. KIM S M, KIM Y N, CHOE Y H. Adenosine-stress dynamic myocardial perfusion imaging using 128-slice dual-source CT:optimization of the CT protocol to reduce the radiation dose[J]. Int J Cardiovasc Imaging, 2013, 29(4):875-884.
19. LIN C J, WU T H, LIN C H, et al. Can iterative reconstruction improve imaging quality for lower radiation CT perfusion? Initial experience[J]. AJNR Am J Neuroradiol, 2013, 34(8):1516-1521.
20. NIESTEN J M, VAN DER SCHAAF I C, RIORDAN A J, et al. Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction[J]. Eur Radiol, 2014, 24(2):484-493.
21. XIE Q, WU J, TANG Y, et al. Whole-organ CT perfusion of the pancreas:impact of iterative reconstruction on image quality, perfusion parameters and radiation dose in 256-slice CT-preliminary findings[J]. PLoS One, 2013, 8(11):e80468.
22. NEGI N, YOSHIKAWA T, OHNO Y, et al. Hepatic CT perfusion measurements:a feasibility study for radiation dose reduction using new image reconstruction method[J]. Eur J Radiol, 2012, 81(11):3048-3054.
23. SPEIDEL M A, BATEMAN C L, TAO Y, et al. Reduction of image noise in low tube current dynamic CT myocardial perfusion imaging using HYPR processing:a time-attenuation curve analysis[J]. Med Phys, 2013, 40(1):011904.
24. KANDA T, YOSHIKAWA T, OHNO Y, et al. Perfusion measurement of the whole upper abdomen of patients with and without liver diseases:initial experience with 320-detector row CT[J]. Eur J Radiol, 2012, 81(10):2470-2475.
25. KAMBADAKONE A R, SHARMA A, CATALANO O A, et al. Protocol modifications for CT perfusion (CTp) examinations of abdomen-pelvic tumors:impact on radiation dose and data processing time[J]. Eur Radiol, 2011, 21(6):1293-1300.
26. TAWFIK A M, RAZEK A A, ELHAWARY G, et al. Effect of increasing the sampling interval to 2 seconds on the radiation dose and accuracy of CT perfusion of the head and neck[J]. J Comput Assist Tomogr, 2014, 38(3):469-473.
27. SCHUHBACK A, MARWAN M, GAUSS S, et al. Interobserver agreement for the detection of atherosclerotic plaque in coronary CT angiography:comparison of two low-dose image acquisition protocols with standard retrospectively ECG-gated reconstruction[J]. Eur Radiol, 2012, 22(7):1529-1536.
28. HABERLAND U, KLOTZ E, ABOLMAALI N. Performance assessment of dynamic spiral scan modes with variable pitch for quantitative perfusion computed tomography[J]. Invest Radiol, 2010, 45(7):378-386.
29. 姜慧杰, 张在人, 赵雁鸣, 等.肝硬化基础上肝癌肝血流变化功能CT灌注成像研究[J].临床放射学杂志, 2012, 31(5):658-662.

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