Kim, S.J.
(Department of Biomedical Engineering, College of Engineering, Seoul National University)
,
Lee, K.H.
(Department of Radiology, College of Medicine, Seoul National University)
,
Kim, J.H.
(Department of Radiology, College of Medicine, Seoul National University)
,
Min, B.G.
(Department of Biomedical Engineering, College of Medicine, Seoul National University)
Contrast-enhanced CT has an important role in the assessment of liver lesions. However, the optimal protocol to get most effective result is not clear. The main principle for deciding injection protocol is to optimize lesion detectability by rapid scanning when lesion-to-liver contrast is maximum. F...
Contrast-enhanced CT has an important role in the assessment of liver lesions. However, the optimal protocol to get most effective result is not clear. The main principle for deciding injection protocol is to optimize lesion detectability by rapid scanning when lesion-to-liver contrast is maximum. For this purpose, we developed a physiological model of contrast medium enhancement based on the compartment modeling and pharmacokinetics. Blood supply to liver was modeled in two paths. This dual supply character distinguishes the CT enhancement of liver from that of the other organs. The first path is by hepatic artery and the second is by portal vein. It is assumed that only hepatic artery can supply blood to hepatocellular carcinoma (HCC) compartment. It is known that this causes the difference of contrast enhancement between normal liver tissue and hepatic tumor. By solving differential equations for each compartment simultaneously using computer program Matlab, CT contrast-enhancement curves were simulated. Simulated enhancement curves for aortic, hepatic, portal vein, and HCC compartments were compared with mean enhancement curves from 24 patients exposed to the same protocols as simulation. These enhancement curves were in a good agreement. Furthermore, we simulated lesion-to-liver curves for various injection protocols, and analyzed the effects. These may help to optimize the scanning protocols for good diagnosis.
Contrast-enhanced CT has an important role in the assessment of liver lesions. However, the optimal protocol to get most effective result is not clear. The main principle for deciding injection protocol is to optimize lesion detectability by rapid scanning when lesion-to-liver contrast is maximum. For this purpose, we developed a physiological model of contrast medium enhancement based on the compartment modeling and pharmacokinetics. Blood supply to liver was modeled in two paths. This dual supply character distinguishes the CT enhancement of liver from that of the other organs. The first path is by hepatic artery and the second is by portal vein. It is assumed that only hepatic artery can supply blood to hepatocellular carcinoma (HCC) compartment. It is known that this causes the difference of contrast enhancement between normal liver tissue and hepatic tumor. By solving differential equations for each compartment simultaneously using computer program Matlab, CT contrast-enhancement curves were simulated. Simulated enhancement curves for aortic, hepatic, portal vein, and HCC compartments were compared with mean enhancement curves from 24 patients exposed to the same protocols as simulation. These enhancement curves were in a good agreement. Furthermore, we simulated lesion-to-liver curves for various injection protocols, and analyzed the effects. These may help to optimize the scanning protocols for good diagnosis.
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