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1 Arts and Sciences CT perfusion CTP Evaluation of meningioma by CT perfusion: Comparison of deconvolution methods Key words: CT Perfusion, meningioma, CBV, CBF, MTT Abstract CT perfusion provides physiologic information about capillary-level hemodynamics and allows evaluation of cerebral perfusion by generating maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). Furthermore, cerebral perfusion is influenced by deconvolution method. We compared two deconvolution methods to estimate CBF and MTT of patients with meningioma. Seventeen subjects with histologically diagnosed meningioma who had undergone CT perfusion using 320 detectorrow CT scan (Aquilion ONE; Toshiba Medical Systems, Tokyo, Japan) were retrospectively reviewed. ROIs were placed on tumor region and were placed on the contralateral normal white matter in each case. CBV ratio (CBV of tumor region / CBV of normal white matter), CBF ratio (CBF of tumor region / CBF of normal white matter) and MTT ratio (MTT of tumor region / MTT of normal white matter) were assessed. Two popular deconvolution methods, block-circulant-svd (b-svd) and standard-svd (s-svd) were compared in CBF ratio and MTT ratio. In all cases, CBF values, CBV values and MTT values were statistically higher in tumor lesions than in normal white matters. Mean CBV ratio was Mean MTT ratio was statistically higher in s-svd ( ) than in b-svd ( ). Mean CBF ratio was higher in b-svd ( ) than in s-svd ( ), but this difference was not significant. Meningiomas demonstrated increased CBV and CBF, but also increased MTT. For evaluation of MTT, s-svd seemed to be more useful than b-svd. CT Perfusion CTP CTP 2block-circulant-SVD b-svd standard-svd s-svd 320 CT17ROI s-svd CTMRI CT dynamic CTA Volume rendering Makoto Koyama 1, Eiji Matsusue 2, Tomoki Oomura 3, Yuina Nagao 1, Tadamasa Ueyama 1, Kazuhiro Sawa 1, Sadaharu Tabuchi 4, Akihito Okamura 1 1 Department of Radiological Technology, Tottori Prefectural Central Hospital 2 Department of Radiology, Tottori Prefectural Central Hospital 3 Department of Radiological Technology, Research Institute for Brain and Blood Vessels Akita 4 Department of Neurosurgery, Tottori Prefectural Central Hospital VR 3 CT CT perfusion CTP CTP 5 6 Deconvolution Singular Value Decomposition SVD 7 cerebral blood volume CBV cerebral blood flow CBFmean transit time MTT CBF CBV/MTT 8 CBV CBV CBV MRI vol.64 no.775

2 9 CBF 9 MTT 9 CTP 10 SVD standard- SVD s-svd blockcirculant-svd b-svd delay-compensated SVD d-svd SVD CBF MTT s-svdmtt CBF b-svd 7 CTP CBVCBF MTT 11 SVD MTTCBF CTP CBV CBF MTT b-svd s-svd MTTCBF CTP Aquilion ONE 80kV 100mA 1 / time density curve TDC 6 2sec mm display Field of view DFOV 240mm 0.5mm AIDR3D75% standard FC41 CT dose index CTDI 176.9mGy 370mgl/ml RI 20G GX7 40ml 40ml 4.0ml/ 6 Ziostation 2 region of interest ROI ROI CBV CBF MTT map ROIFig ROI TDC 12.4cm cm cm cm cm cm 2 Fig.1 CBF MTT b-svd s-svd ROI ROIROI CBV MTTCBF map ROI ROI MTT CBF b-svd s-svd CBVCBV CBV CBF CBF CBF MTTMTT MTT CBF MTT b-svd s-svd Mann-Whitney U p<0.05 CBV ml/100g ml/100g P<0.001 Fig.4 MTT

3 Fig.1 代表例におけるCBV map ROIの配置位置およびtime density curve TDC A 造影 CT C CBV map 腫瘍レベル B 動脈赤線と髄膜腫青線の TDC D CBV map 半卵円中心レベル前頭葉底部に面する強い増強効果を示す腫瘤 A 矢印において CBV の強い増加が認められる 2 2 C 矢印 ROI の面積は腫瘍 0.31cm C 白質 1.85cm D CBV 比はであった Fig.2 代表例における b-svd法 A B およびs-SVD法 C D によるMTT map Fig.3 代表例における b-svd法 A B およびs-SVD法 C D によるCBF map 右前頭葉に面する腫瘍部 A C 矢印はいずれも MTT の延長が見られるが b-svd 法 A と比べて s-svd 法 C の方が白質とのコントラストが高くなっている b-svd 法の MTT 比は 1.69 s-svd 法の MTT 比は 2.17 であった右前頭葉に面する腫瘍部 A C 矢印はいずれも CBF の増加が見られるが b-svd 法 C と比べて s-svd 法 A は腫瘍部と白質とのコントラストが若干高くなっている. b-svd 法の CBF 比は s-svd 法の CBF 比は 11.7 であった日本診療放射線技師会誌 vol.64 no.775

CT perfusion CTP Arts and Sciences Fig.4 CBV 17.3 14.4 ml/100g 1.4 0.3 ml/100g Fig.7 CBV 12.

0 sec Fig.8 A b-svd s-svdmtt b-svd 1.79 0.45 s-svd 2.69 1.56 B b-svd s-svdcbf b-svd 7.97 8.

2 ml/100g/min B s-svd CBF 96.7 77.3 ml/100g/min 22.7 6.4 ml/100g/min b-svd 6.8 1.9sec s-svd 5.

2ml/100g/min s-svd 22.7 6.4ml/100g/min b-svd 92.4 72.4ml/100g/min s-svd 96.7 77.

4 CT perfusion CTP Arts and Sciences Fig.4 CBV ml/100g ml/100g Fig.7 CBV Fig.5 A b-svd MTT sec sec B s-svd MTT sec sec Fig.8 A b-svd s-svdmtt b-svd s-svd B b-svd s-svdcbf b-svd s-svd Fig.6 A b-svd CBF ml/100g/min ml/100g/min B s-svd CBF ml/100g/min ml/100g/min b-svd sec s-svd sec b-svd sec s-svd sec P<0.001 Fig.5 CBF b-svd ml/100g/min s-svd ml/100g/min b-svd ml/100g/min s-svd ml/100g/min P<0.001 Fig.6 CBV Fig.7 MTTb-SVD s-svd s-svd P Fig.8 A CBF b-svd s-svd b-svd p Fig.8 B

5 CBV MTT CBF CBV CBV CTP CBV 12 MTT MTT 3 MTT 12 b-svd s-svd b-svds-svd CBF CBV >CBF >MTT CBF CBV MTT CBF MTT CBV CBF b-svd s-svd b-svd CBF MTT Deconvolution s-svd ROI CBV CBF MTT MTT CBFs-SVD b-svd MTT b-svc s-svd 1 Cenic A, et al.: A CT method to measure hemodynamics in brain tumors: validation and application of cerebral blood flow maps. Am J Neuroradiol, 21, , Eastwood J, et al.: Cerebral blood flow, blood volume, and vascular permeability of cerebral glioma assessed with dynamic CT perfusion imaging. Neuroradiol, 45, , Ding B, et al.: Comparison of cerebral blood volume and permeability in preoperative grading of intracranial glioma using CT perfusion imaging. Neuroradiol, 48, , Nallo A, et al.: Quantitative analysis of CT-perfusion parameters in the evaluation of brain gliomas and metastases. J Exp Clin Canc Res, 28-38, Klotz E, et al.: Perfusion measurements of the brain: using dynamic CT for the quantitative assessment of cerebral ischemia in acute stroke. Eur J Radiol, , 30, Mayer T, et al.: Dynamic CT perfusion imaging of acute stroke. Am J Neuroradiol, 21, , CT MRI., 25, , Meier P, et al.: On the theory of the indicator-dilution method for measurement of blood flow and volume. J Appl Physiol, 6, , CT/MR CT/ MR Calamante F, et al.: Delay and dispersion effects in dynamic susceptibility contrast MRI. Magn Reson Med, 44, , Sergides I, et al.: Utilization of dynamic CT perfusion in the study of intracranial meningiomas and their surrounding tissue. Neuro Research, 31, 84-89, CT., 54, 4-19, vol.64 no.775

1219 Fig. 1 Procedure for creating a digital phantom for CT (a) Step 1. Agar phantoms adjusted to give CT values of 0 HU and 20 HU were allowed to har

1219 Fig. 1 Procedure for creating a digital phantom for CT (a) Step 1. Agar phantoms adjusted to give CT values of 0 HU and 20 HU were allowed to har 1218 原著 2013 6 4 2013 9 13 Code Nos. 251 883 CT-Perfusion 大村知己豊嶋英仁佐藤祐一郎石田嵩人緒言 Computed tomography CT 320 multi-detector row CT 320MDCT 160 mm 1 CT CT-perfusion: CTP CT angiography 4D-CTA 1, 2 CTP mean