Multiphasic Dynamic Computed Tomography Evaluation of Liver Tissue Perfusion Characteristics Using the Dual Maximum Slope Model in Patients With Cirrhosis and Hepatocellular Carcinoma: A Feasibility Study

Objective The aim of this study was to investigate the feasibility of multiphasic dynamic computed tomography (CT) scans in providing liver tissue perfusion characteristics using the dual maximum slope model in patients with liver cirrhosis and hepatocellular carcinoma (HCC). Materials and Methods With institutional review board approval and acquisition of informed consent, we retrospectively analyzed the prospectively collected perfusion CT (PCT) data of 36 patients enrolled in a prospective clinical trial for pretherapeutic assessment of HCC. To obtain perfusion parameters including arterial liver perfusion (ALP), portal venous perfusion (PVP), and the hepatic perfusion index (HPI), 5-phase dynamic CT data sets with triple arterial phases including peak aortic and splenic enhancement information were selected from the PCT data sets. The PCT and 5-phase dynamic CT data sets extracted from the PCT data were analyzed using dedicated perfusion software based on the dual maximum slope model. Comparisons between the perfusion parameters of each method were performed using Wilcoxon signed rank test and intraclass correlation coefficients. Results The extraction of liver perfusion parameters from 5-phase dynamic CT scans was feasible using the dual maximum slope model, and no significant differences were observed between perfusion parameters obtained from 5-phase dynamic CT and from PCT in the liver parenchyma (ALP, P = 0.137; PVP, P = 0.110; HPI, P = 0.793) and in HCCs (ALP, P = 0.162; HPI, P = 0.131). Regarding intraclass correlation coefficients, excellent agreement was observed between perfusion parameters obtained using 5-phase dynamic CT and from PCT in both the liver parenchyma (ALP, 0.793; PVP, 0.831; HPI, 0.934) and in HCCs (ALP, 0.889; HPI, 0.943). Conclusions The extraction of liver perfusion parameters from 5-phase dynamic CT scans was feasible using the dual maximum slope model and provided comparable values to those obtained from PCT.