Evaluation eines hepatischen Perfusionsindex zur Früherkennung von Tumorrezidiven nach RFA und Erkennung von Leber-Malignomen bei Leberzirrhose

The purpose of this dissertation was to investigate the diagnostic value of the volumetric arterial enhancement fraction (AEF) of the liver with color mapping for the early detection of tumor relapse after hepatic radiofrequency ablation (RFA) and for malignant liver tumor in liver cirrhosis. Quantitative AEF color maps of the whole liver were computed from triple phase contrast-enhanced multislice computed tomography (MSCT) images. Follow-up examinations served as standard of reference. The diagnostic performance of the AEF color maps to predict subsequent tumor occurrence before it was visible on routine multiphase CT images was evaluated with receiver-operating characteristic (ROC) analysis. Wilcoxon test was used to check quantitative AEF differences between diseased and normal liver. The mean AEF of segments that developed metastases was significantly higher (62±23%) when compared to the mean of segments that did not develop metastases (39±20%;p<0.0001). ROC analysis revealed a probability of 77% for AEF values to be higher in case of subsequent metastases as compared to liver parenchyma without tumor recurrence. An AEF threshold of 50% resulted in a sensitivity of 67% and a specificity of 75% for the early detection of liver metastasis before they become visible on routine contrast CT images. Also results for HCC detection and liver cirrhosis were promising. In conclusion AEF provides incremental value in the postinterventional imaging surveillance after RFA for liver metastases. AEF color maps may be suited to predict tumor recurrence earlier than routine assessment of contrast enhanced MSCT. In conclusion, whole liver AEF color maps computed from routine CT data provides visual and quantitative information about the state of perfusion of the liver. This technique has the potential to improve the early detection of recurrent tumor after RFA of liver metastases and should be integrated into the routine assessment of contrast enhanced CT after local tumor ablation.

Grantor dc:publisher

Publikationsserver der RWTH Aachen University

Year dc:date

2009

Author dc:creator

• Schreiber, Sara

Contributors dc:contributor

• Mahnken, Andreas H.

• info:eu-repo/classification/ddc/610
• Metastase
• Leber
• Leberzirrhose
• Frühdiagnostik
• Medizin
• RFA
• HCC
• Farbkarte
• HPI
• color map
• AEF

Statement dc:rights

• info:eu-repo/semantics/openAccess

Language dc:language

ger

Identifier

https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113844%22

OAI record oai:identifier

https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51563