open access

Vol 25, No 2 (2020)
Original research articles
Published online: 2020-03-01
Submitted: 2019-09-23
Get Citation

Feasibility of 4D CT simulation with synchronized intravenous contrast injection in hepatocellular carcinoma

Anil Gupta, Rishabh Kumar, Hanuman Prasad Yadav, Manik Sharma, Rose Kamal, Deepak Thaper, Prabir Banik, Shipra Gupta, Kartik Saroha, Sandeep Singh, Shiv Kumar Sarin
DOI: 10.1016/j.rpor.2019.12.006
·
Rep Pract Oncol Radiother 2020;25(2):293-298.

open access

Vol 25, No 2 (2020)
Original research articles
Published online: 2020-03-01
Submitted: 2019-09-23

Abstract

Background

Delivering Stereotactic Body Radiotherapy (SBRT) for Hepatocellular Carcinoma (HCC) is challenging mainly for two reasons: first, motion of the liver occurs in six degrees of freedom and, second, delineation of the tumor is difficult owing to a similar density of HCC to that of the adjoining healthy liver tissue in a non-contrast CT scan. To overcome both these challenges simultaneously, we performed a feasibility study to synchronize intravenous contrast to obtain an arterial and a delayed phase 4D CT.

Materials and Methods

We included seven HCC patients of planned for SBRT. 4D CT simulation was performed with synchronized intravenous contrast based on the formula TSCAN DELAY = Tpeak – (L0/Detector Coverage × Cine Duration in Seconds). This was followed by a delayed 4D CT scan.

Results

We found that, with our protocol, it is feasible to obtain a 4DCT with an arterial and a delayed phase making it comparable to a diagnostic multi-phase CT. The peak HU of the 4D scan and diagnostic CT were similar (mean peak HU 134.2 vs 143.1, p value = 0.58 N.S). Whereas in comparison with a non-contrast CT a significant rise in the peak HU was seen (mean peak 134.2 vs 61.4 p value = .00003).

Conclusion

A synchronized contrast 4D CT simulation for HCC is safe and feasible. It results in good contrast enhancement comparable to a diagnostic 3D contrast CT scan.

Abstract

Background

Delivering Stereotactic Body Radiotherapy (SBRT) for Hepatocellular Carcinoma (HCC) is challenging mainly for two reasons: first, motion of the liver occurs in six degrees of freedom and, second, delineation of the tumor is difficult owing to a similar density of HCC to that of the adjoining healthy liver tissue in a non-contrast CT scan. To overcome both these challenges simultaneously, we performed a feasibility study to synchronize intravenous contrast to obtain an arterial and a delayed phase 4D CT.

Materials and Methods

We included seven HCC patients of planned for SBRT. 4D CT simulation was performed with synchronized intravenous contrast based on the formula TSCAN DELAY = Tpeak – (L0/Detector Coverage × Cine Duration in Seconds). This was followed by a delayed 4D CT scan.

Results

We found that, with our protocol, it is feasible to obtain a 4DCT with an arterial and a delayed phase making it comparable to a diagnostic multi-phase CT. The peak HU of the 4D scan and diagnostic CT were similar (mean peak HU 134.2 vs 143.1, p value = 0.58 N.S). Whereas in comparison with a non-contrast CT a significant rise in the peak HU was seen (mean peak 134.2 vs 61.4 p value = .00003).

Conclusion

A synchronized contrast 4D CT simulation for HCC is safe and feasible. It results in good contrast enhancement comparable to a diagnostic 3D contrast CT scan.

Get Citation

Keywords

Index terms – hepatocellular carcinoma; 4DCT simulation; Synchronized intravenous contrast scans; Target delineation

About this article
Title

Feasibility of 4D CT simulation with synchronized intravenous contrast injection in hepatocellular carcinoma

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 25, No 2 (2020)

Pages

293-298

Published online

2020-03-01

DOI

10.1016/j.rpor.2019.12.006

Bibliographic record

Rep Pract Oncol Radiother 2020;25(2):293-298.

Keywords

Index terms – hepatocellular carcinoma
4DCT simulation
Synchronized intravenous contrast scans
Target delineation

Authors

Anil Gupta
Rishabh Kumar
Hanuman Prasad Yadav
Manik Sharma
Rose Kamal
Deepak Thaper
Prabir Banik
Shipra Gupta
Kartik Saroha
Sandeep Singh
Shiv Kumar Sarin

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: journals@viamedica.pl