scholarly journals Perfusion Computed Tomography Scan Imaging in Differentiation of Benign from Malignant Parotid Lesions

2019 ◽  
Vol 24 (02) ◽  
pp. e160-e169
Author(s):  
Masume Niazi ◽  
Maryam Mohammadzadeh ◽  
Kayvan Aghazadeh ◽  
Hashem Sharifian ◽  
Ebrahim Karimi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Parotid Gland ◽  
Malignant Tumors ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Perfusion Ct ◽  
Perfusion Computed Tomography ◽  
Parotid Tumors ◽  
The Mean ◽  
Malignant Parotid Tumors

Abstract Introduction The most common site of salivary gland tumors is the parotid gland. Computed tomography (CT), magnetic resonance imaging (MRI), and sonography are imaging modalities to differentiate benign from malignant parotid tumors. Objective The aim of this study is the evaluation of the diagnostic value of perfusion CT for differentiating histological categorization of benign and malignant parotid tumors. Methods A total of 29 patients with parotid neoplasms were enrolled in this study. Mean age and all CT perfusion variables (gradient and permeability, blood flow [BF], blood volume [BV], mean transit time [MTT], permeability surface [PS], maximum intensity projection [MIP], time-density curve [TDC], and time to peak [TTP]) were compared among three groups (malignant tumors [MTs], Warthin's tumor [WT] and pleomorphic adenomas [PA]). Results The mean age of the patients was 55.9 ± 14.1 (26–77), and 15 of them were male (51.7%). Eleven lesions were PAs [37.9%], 8 lesions were WTs (27.6%0 and 10 lesions (34.5%) were MTs (6 acinic cell carcinomas [ACCs], 3 adenocystic carcinomas [AdCCs], and 1 mucoepidermoid carcinoma [MEC]). The mean age of the patients with WTs was 62 ± 7.5 years; 52 ± 14.2 for patients with Pas, and 55.2 ± 17.2 for those with MTs (p = 0.32). The mean MIP was 122.7 ± 12.2 in WT, while it was 80.5 ± 19.5 in PA, and 76.2 ± 27.1 in MTs (p < 0.001); The mean MIP for WT was higher than for PAs and MTs; the values of MTs and PAs were not statistically different. The average of BF, BV, and curve peak were higher in WTs in comparison with the other two groups, and curve time 2 and TTP were higher in PAs in comparison with MTs. Conclusion Based on this study, perfusion CT of the parotid gland and its parameters can distinguish between benign and malignant parotid masses.

Abstract P140: Do Perfusion Computed Tomography Abnormalities in Patients With Transient Ischemic Attack Predict Subsequent Ischemic Stroke and Cardiovascular Event

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Aisha Abdulrazaq ◽  
Muhammad F Ishfaq ◽  
Sachin Bhagavan ◽  
Ammad Ishfaq ◽  
Brandi R French ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Cardiovascular Events ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Imaging Protocol ◽  
Perfusion Computed Tomography ◽  
Blood Flow Reduction ◽  
Ischemic Attack

Background and purpose: To determine if computed tomography (CT) perfusion (CTP) abnormalities in patients with transient ischemic attacks (TIA) are associated with development of ischemic strokes or adverse cardiovascular events within 24 months. Methods: Patients with a diagnosis of TIA who underwent CTP within 24 hours of symptom onset as part of the stroke/TIA imaging protocol were analysed. Abnormality was defined as an area of well demarcated mean transit time delay and/or cerebral blood flow reduction corresponding to an arterial territory as identified by an independent neuroradiologist. The patients were followed for at least 3 months and up to 24 months to identify occurrence of ischemic stroke and cardiovascular events (myocardial infarction or ischemia). Results: A total of 78 patients (mean age 67.60 +/- 15.1 ; 48 were men) with a diagnosis of TIA. A total of 17 patients (22%) had documented CTP abnormalities. Patients with CTP abnormalities were older and more likely to be men. There was no difference in the rates of ischemic stroke (5.9 % vs 3.3 %), or cardiovascular events (0% versus 1.6 %) when patients with CTP abnormalities were compared to those with normal CTP. Conclusions: In patients with TIA, an abnormal CTP does not predict the occurence of new ischemic stroke or cardiovascular events during follow up.

Use-fullness of dynamic contrast-enhanced MR imaging and diffusion weighted MR imaging for differentiation of benign and malignant parotid tumors

2018 ◽  
pp. 1-6
Keyword(s):  
Mr Imaging ◽  
Malignant Tumors ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Parotid Tumors ◽  
Contrast Enhanced ◽  
Type C ◽  
Sensitivity Specificity ◽  
And Diffusion ◽  
Malignant Parotid Tumors

Objectives: To evaluate the usefullness of dynamic contrast-enhanced MR Imaging (DCE-MRI) and diffusion weighted imaging (DWI) for differentiating benign from malignant parotid tumors. Methods: Prospectively,DCE-MRI and DWI were performed in 112 patients, with 148 confirmed parotid masses. The differential optimal thresholds were determined. Results: WConsidering tumors with time-intensity curve (TIC) Type C as malignant, sensitivity, specificity, accuracy were 95%, 76%, 79%, respectively. Considering ADC threshold values 0.709×10-3mm2 /s<ADC<0.948×10-3mm2 /s as malignant, sensitivity, specificity, accuracy were 75%, 78%, 78%, respectively. Considering TIC Type C and ADC values 0.709×10-3mm2 /s<ADC<0.948×10-3mm2 /s as malignant, sensitivity, specificity, accuracy were 75%, 91%, 89%, respectively. With threshold Kep<1.118 min-1 and Ve >0.315 between Warthin and malignant tumors, threshold Kep>0.555 min-1 and Ve <0.605 between pleomorphic adenomas and malignant tumors, sensitivity, specificity, accuracy for malignancy were 70% vs 90%, 96% vs 74%, 92% vs 80%, respectively. Conclusion: DCE-MRI and DWI provide more information in differentiating benign from malignant parotid tumors.

scholarly journals Computed tomography perfusion as a predictor of delayed cerebral ischemia and functional outcome in spontaneous subarachnoid hemorrhage: A single center experience

2019 ◽  
Vol 32 (3) ◽  
pp. 179-188 ◽  
Author(s):  
Isabel Fragata ◽  
Marta Alves ◽  
Ana Luísa Papoila ◽  
Ana Paiva Nunes ◽  
Patrícia Ferreira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Ischemia ◽  
Clinical Outcome ◽  
Cerebral Perfusion ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Multivariable Analysis ◽  
Delayed Cerebral Ischemia ◽  
Spontaneous Subarachnoid Hemorrhage

Background Computed tomography (CT) perfusion has been studied as a tool to predict delayed cerebral ischemia (DCI) and clinical outcome in spontaneous subarachnoid hemorrhage (SAH). The purpose of the study was to determine whether quantitative CT perfusion performed within 72 hours after admission can predict the occurrence of DCI and clinical outcome as measured with a modified Rankin scale (mRS) at 3 months after ictus. Methods Cerebral perfusion was assessed in a prospective cohort of patients with acute SAH. CT perfusion parameters at <72 h post SAH were quantitatively measured in the main vascular territories and represented as whole-brain means. Spearman rank correlation coefficient and generalized additive regression models for binary outcome were used. Results A total of 66 patients underwent CT perfusion at <72 h. Poor clinical grade on admission was correlated with worse cerebral perfusion in all parameters. Multivariable analysis yielded an association of time to peak (TTP; odds ratio (OR) = 0.89; 95% confidence interval (CI): 0.77, 1.02; p = 0.083) with the occurrence of DCI. We also found an association of TTP values with poor outcome, with an 8% increase in the odds of mRS > 3 for each one second increase in TTP at admission (OR = 1.08; 95% CI: 1.00, 1.17; p = 0.061). Conclusions We identified an association of early TTP changes with DCI and poor clinical outcome. However, there were no associations with cerebral blood flow or mean transit time and DCI/clinical outcome. CT perfusion still remains to be validated as a tool in predicting outcome in SAH.

Malignant Parotid Tumors Diagnostic Considerations and Therapeutic Suggestions

1989 ◽  
Vol 75 (1) ◽  
pp. 53-56 ◽  
Author(s):  
Lippo Lippi ◽  
Wolfango De Meester ◽  
Alessandro Norberti ◽  
Paolo Porzio
Keyword(s):  
Cell Carcinoma ◽  
Malignant Tumors ◽  
Parotid Tumors ◽  
Adenoid Cystic ◽  
Therapeutic Protocol ◽  
The Moment ◽  
Lost To Follow Up ◽  
Malignant Parotid Tumors ◽  
Mixed Tumors

This paper presents our experience of the problem of diagnosis and surgical treatment of malignant parotid tumors, based on a retrospective evaluation of a series of 478 parotid tumors, of which 100 were malignant. Out of 75 primaris malignant tumors of epithelial origin, 35 belonged to the « epidermoid » group (adenocarcinomas, undifferentiated carcinomas, malignant mixed tumors, squamous cell carcinoma), 20 were muco-epidermoid carcinomas, 15 adenoid cystic carcinomas and 5 were acinic cell carcinoma. Altogether, 58.7% of the treated patients do not at the moment present evidence of disease; 33.3% are dead from the disease or are alive with active disease; 5.3% are dead from other causes and 2.7% are lost to follow-up. Underlining the importance of histologic examination of the swelling by intraoperative biopsy, the authors propose a diagnostic and therapeutic protocol.

Malignant Epithelial Tumors of the Parotid Gland

2021 ◽  
pp. 213-232
Keyword(s):  
Parotid Gland ◽  
Cell Carcinoma ◽  
De Novo ◽  
Malignant Tumors ◽  
Large Cell Carcinoma ◽  
Low Grade ◽  
Parotid Tumors ◽  
Characteristic Features ◽  
Epithelial Myoepithelial Carcinoma ◽  
The Individual

Cancer of the parotid gland represents about 20% of all parotid tumors. It either occurs “de-novo” or “on top of pleomorphic adenoma.” There is no sex predilection, and the age of developing this cancer is usually above 50 years. Malignant tumors are as varied as their benign counterparts. Certain tumors are “low-grade” (polymorphous low-grade adenocarcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma), while others are “high-grade” (salivary duct carcinoma, large cell carcinoma, and small cell carcinoma). The first echelon lymph node (LN) of metastases is the intra- and peri-glandular nodes. The next echelon is level II LNs. Hematogenous spread occurs very late and is mainly to the lungs and bones. However, adenoid cystic carcinoma tends to grow through peri-neural lymphatics with increased risk of nerve involvement, intra-cranial extension, and increased rate of recurrence. In this chapter, characteristic features and management of the individual types of malignant parotid tumors will be discussed.

Identification of Local Recurrence and Radiofibrosis by Computed Tomography Perfusion on Nasopharyngeal Carcinoma after Radiotherapy

2010 ◽  
Vol 61 (5) ◽  
pp. 265-270 ◽  
Author(s):  
Danke Su ◽  
Guanqiao Jin ◽  
Dong Xie ◽  
Younan Liu
Keyword(s):  
Computed Tomography ◽  
Blood Flow ◽  
Nasopharyngeal Carcinoma ◽  
Local Recurrence ◽  
Microvessel Density ◽  
Mean Transit Time ◽  
Perfusion Ct ◽  
Permeability Surface ◽  
Area Product ◽  
Time Density

Purpose The aim of this study was to investigate the role of perfusion computed tomography (CT) for identification of local recurrence (LR) and radiofibrosis (RF) in patients with nasopharyngeal carcinoma after radiotherapy. Methods Forty-eight prospective patients were recruited for this study. NPC diagnosis was confirmed by pathologic biopsy examination. Immunohistochemistry staining was used on biopsy specimens, and microvessel density was calculated by microscopy. Perfusion CT was performed on both the LR group ( n = 31) and the RF group ( n = 17) after intravenous injection of contrast medium. Time-density curve, blood flow, blood volume, and mean transit time, as well as permeability surface area product, were analyzed as perfusion CT parameters. The microvessel density was compared between both the LR and RF groups. Results There is a significant difference between the LR and RF groups in microvessel density, the time density curve, blood flow blood volume, mean transit time, and the permeability surface area product ( P < .01). Conclusions The results demonstrate that perfusion CT is a reliable and accurate method to identify LR and RF after radiotherapy in patients with nasopharyngeal carcinoma.

scholarly journals Utility of computed tomography perfusion in detection of cerebral vasospasm in patients with subarachnoid hemorrhage

2006 ◽  
Vol 21 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Roham Moftakhar ◽  
Howard A. Rowley ◽  
Aquilla Turk ◽  
David B. Niemann ◽  
Beverly Aagaard Kienitz ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Subarachnoid Hemorrhage ◽  
Cerebral Vasospasm ◽  
Cerebral Blood Volume ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Digital Subtraction ◽  
Noninvasive Method ◽  
Computed Tomography Perfusion ◽  
Intent To Treat

Object Digital subtraction (DS) angiography is the gold standard for detecting cerebral vasospasm after subarachnoid hemorrhage (SAH). Computed tomography (CT) perfusion is a recently developed modality for the evaluation of cerebral hemodynamics. This study was conducted to evaluate the potential of using CT perfusion to detect vasospasm in patients with SAH. Methods Fourteen patients between the ages of 41 and 66 years with aneurysmal SAH underwent 23 CT perfusion scans for suspected vasospasm. All patients underwent DS angiography within 12 hours of the CT perfusion scans. The presence of vasospasm on CT perfusion images was determined based on qualitative reading using color maps of mean transit time, cerebral blood flow, and cerebral blood volume as criteria. The presence or absence of vasospasm as retrospectively determined using CT perfusion was compared with DS angiography findings. Of the 23 CT perfusion scans performed, 21 (91%) were concordant with angiography findings in predicting the presence or absence of vasospasm. In 15 of 23 scans, the presence of vasospasm was detected on CT perfusion scans and confirmed on DS angiography studies. In two cases, vasospasm was revealed on DS angiography but was not confirmed on CT perfusion. The degree of agreement between CT perfusion and DS angiography for detection of vasospasm was high (κ = 0.8, p < 0.0001). Conclusions Computed tomography perfusion is an accurate, reliable, and noninvasive method to detect the presence or absence of vasospasm. It can be used as a tool to help guide the decision to pursue DS angiography with the intent to treat vasospasm.

scholarly journals Information technology for the analysis of CT perfusion in assessing the effectiveness of treatment for glioblastoma

2020 ◽  
Vol 7 (3) ◽  
pp. 83-90
Author(s):  
A. V. Balandina ◽  
P. M. Zelter ◽  
A. V. Kapishnikov ◽  
S. V. Kozlov ◽  
A. V. Kolsanov ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Information Technology ◽  
Diagnostic Method ◽  
Radiation Necrosis ◽  
Ct Perfusion ◽  
Perfusion Computed Tomography ◽  
Equipment Manufacturer ◽  
Post Radiation ◽  
Computed Tomograph ◽  
Perfusion Mode

Purpose of the study. To develop an information technology for calculating perfusion computed tomography parameters and to evaluate the effectiveness of using the proposed program in the differential diagnosis of continued glioblastoma growth and post-radiation necrosis. Materials and methods. We examined 53 patients who were treated at the Samara Clinical Oncological Dispensary. All patients underwent CT scan in perfusion mode. The results of using the program were compared with the data that were calculated on the workstation of the GE Discovery CT750 HD computed tomograph. Results. Significant differences were found in CBV and CBF perfusion indices in groups with continued growth and post-radiation necrosis, verified by biopsy. The parameters calculated using the developed program did not differ significantly from the results obtained on a standard workstation. Conclusion. The application of the developed computer program for the analysis of CT perfusion does not depend on the equipment manufacturer, works with standard DICOM data, which increases the availability of a valuable diagnostic method. The results obtained using the proposed information technology make it possible to differentiate the continued growth of glioblastoma from post-radiation necrosis.

scholarly journals Reliability of CT Perfusion-Derived CBF in Relation to Hemodynamic Compromise in Patients with Cerebrovascular Steno-Occlusive Disease: A Comparative Study with 15O PET

2015 ◽  
Vol 35 (8) ◽  
pp. 1280-1288 ◽  
Author(s):  
Masanobu Ibaraki ◽  
Tomomi Ohmura ◽  
Keisuke Matsubara ◽  
Toshibumi Kinoshita
Keyword(s):  
Computed Tomography ◽  
Singular Value Decomposition ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Accurate Method ◽  
Singular Value ◽  
Occlusive Disease ◽  
Deconvolution Analysis ◽  
Hemodynamic Compromise ◽  
Value Decomposition

In the bolus tracking technique with computed tomography (CT) or magnetic resonance imaging, cerebral blood flow (CBF) is computed from deconvolution analysis, but its accuracy is unclear. To evaluate the reliability of CT perfusion (CTP)-derived CBF, we examined 27 patients with symptomatic or asymptomatic unilateral cerebrovascular steno-occlusive disease. Results from three deconvolution algorithms, standard singular value decomposition (sSVD), delay-corrected SVD (dSVD), and block-circulant SVD (cSVD), were compared with 15O positron emission tomography (PET) as a reference standard. To investigate CBF errors associated with the deconvolution analysis, differences in lesion-to-normal CBF ratios between PET and CTP were correlated with prolongation of arterial-tissue delay (ATD) and mean transit time (MTT) in the lesion hemisphere. Computed tomography perfusion results strongly depended on the deconvolution algorithms used. Standard singular value decomposition showed ATD-dependent underestimation of CBF ratio, whereas cSVD showed overestimation of the CBF ratio when MTT was severely prolonged in the lesions. The computer simulations reproduced the trend observed in patients. Deconvolution by dSVD can provide lesion-to-normal CBF ratios less dependent on ATD and MTT, but requires accurate ATD maps in advance. A practical and accurate method for CTP is required to assess CBF in patients with MTT-prolonged regions.

scholarly journals Role of Perfusion CT Differentiating Hemangiomas from Malignant Hepatic Lesions

2014 ◽  
Vol 4 ◽  
pp. 10 ◽  
Author(s):  
Jagjeet Singh ◽  
Sanjiv Sharma ◽  
Neeti Aggarwal ◽  
R G Sood ◽  
Shikha Sood ◽  
...  
Keyword(s):  
Predictive Value ◽  
Multidetector Ct ◽  
Ct Perfusion ◽  
Mean Transit Time ◽  
Liver Parenchyma ◽  
Study Data ◽  
Perfusion Ct ◽  
Hepatic Malignancy ◽  
Hepatic Lesions

Objective: The purpose of the study was to determine the role of computed tomography (CT) perfusion in differentiating hemangiomas from malignant hepatic lesions. Materials and Methods: This study was approved by the institutional review board. All the patients provided informed consent. CT perfusion was performed with 64 multidetector CT (MDCT) scanner on 45 patients including 27 cases of metastasis, 9 cases of hepatocellular carcinoma (HCC), and 9 cases of hemangiomas. A 14 cm span of the liver was covered during the perfusion study. Data was analyzed to calculate blood flow (BF), blood volume (BV), permeability surface area product (PS), mean transit time (MTT), hepatic arterial fraction (HAF), and induced residue fraction time of onset (IRFTO). CT perfusion parameters at the periphery of lesions and background liver parenchyma were compared. Results: Significant changes were observed in the perfusion parameters at the periphery of different lesions. Of all the perfusion parameters BF, HAF, and IRFTO showed most significant changes. In our study we found: BF of more than 400 ml/100 g/min at the periphery of the hemangiomas showed sensitivity of 88.9%, specificity of 83.3%, positive predictive value (PPV) of 57.1%, and negative predictive value (NPV) of 96.7% in differentiating hemangiomas from hepatic malignancy; HAF of more than 60% at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3% and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy; IRFTO of more than 3 s at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3%, and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy. Conclusion: Perfusion CT is a helpful tool in differentiating hemangiomas from hepatic malignancy by its ability to determine changes in perfusion parameters of the lesions.

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