A comparative study between arterial spin labeling and CT perfusion methods on hepatic portal venous flow

Area of Science:

• Radiology
• Medical Imaging
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) diagnosis and management rely on accurate liver perfusion assessment.
• Unenhanced techniques are desirable to reduce patient burden and potential risks.
• Arterial spin labeling (ASL) offers a non-invasive method for perfusion imaging.

Purpose of the Study:

• To assess the feasibility and clinical utility of unenhanced MR hepatic portal perfusion imaging.
• To evaluate the technique in both healthy individuals and patients with HCC.
• To compare ASL-derived perfusion with computed tomography (CT) perfusion.

Main Methods:

• Unenhanced MR perfusion using ASL was performed in 5 healthy volunteers and 12 HCC patients.
• Volunteers underwent varying inversion time 2 (TI2) values (2000-4000 ms).
• Patients had both ASL MR and CT perfusion during superior mesenteric artery (SMA) portography; regions of interest were placed in liver lobes/segments and tumors.

Main Results:

• Hepatic parenchyma perfusion peaked at a TI2 of 3000 ms in healthy volunteers (254.3 ml/min/100 g ± 58.3).
• A significant fair correlation (r = 0.795, P < 0.01) was found between ASL MR perfusion and CT perfusion in patients.
• ASL demonstrated good correlation with CT perfusion during SMA portography.

Conclusions:

• Unenhanced MR hepatic portal perfusion imaging with ASL is feasible.
• The technique shows a fair correlation with CT perfusion, suggesting its potential usefulness.
• ASL provides a viable non-invasive alternative for assessing liver perfusion in HCC contexts.