Deconvolution assessment of splenic and splanchnic contributions to portal venous blood flow in liver cirrhosis

Authors

  • San Koh Tong,

    1. Department of Oncologic Imaging, National Cancer Centre, 11 Hospital Drive, Singapore 169610; Duke-NUS Graduate Medical School, 8 College Road, Singapore 169547; and School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Drive, Singapore 639798
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    • a)

      Author to whom correspondence should be addressed. Electronic mail: etskoh@ntu.edu.sg; Telephone: (65) 6790 4218; Fax: (65) 6792 0415.

  • Hua Thng Choon,

    1. Department of Oncologic Imaging, National Cancer Centre, 11 Hospital Drive, Singapore 169610 and Duke-NUS Graduate Medical School, 8 College Road, Singapore 169547
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  • Hartono Septian,

    1. Department of Oncologic Imaging, National Cancer Centre, 11 Hospital Drive, Singapore 169610 and School of Electrical and Electronic Engineering, Nanyang Technological University, 50 Nanyang Drive, Singapore 639798
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  • Pin Choo Su,

    1. Department of Medical Oncology, National Cancer Center, 11 Hospital Drive, Singapore 169610
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  • Sing Ng Quan,

    1. Department of Medical Oncology, National Cancer Center, 11 Hospital Drive, Singapore 169610
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  • Khoo James B. K.,

    1. Department of Oncologic Imaging, National Cancer Centre, 11 Hospital Drive, Singapore 169610
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  • Bisdas Sotirios,

    1. Department of Radiology, Eberhard Karls University, Hoppe-Seyler-Straße 3, D-72076 Tübingen, Germany
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  • Mu Koh Dow

    1. Department of Radiology, Royal Marsden NHS Foundation Trust, Sutton, Surrey SM2 5PT, United Kingdom
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Abstract

Purpose:

To devise a noninvasive imaging method for resolving the relative contribution of splenic and splanchnic blood flow to portal venous flow and derive quantitative estimates for parameters pertaining to splenic and portal hemodynamics.

Methods:

Tracer concentration–time curves of the aorta, portal vein, and spleen can be extracted from dynamic contrast-enhanced (DCE) CT or MR images. A combination of two tracer analysis approaches, namely arterial–venous sampling and residual tracer deconvolution, is proposed to model these concentration–time curves and derive hemodynamic parameters pertaining to splenic and portal circulation. Clinical feasibility of the proposed method was explored using DCE CT datasets of eight cirrhotic patients. Monte Carlo simulations were performed to evaluate the confidence of the parameter estimates.

Results:

Portal blood flow was estimated to be 763.8 ± 438.1 ml/min in cirrhotic patients and the splenic contribution was found to be elevated (0.75 ± 0.22). Estimates of splenic blood flow (582 ± 420 ml/min) and transit time (15.3 ± 10.1 s) in cirrhotic patients were consistent with reported values obtained using duplex Doppler ultrasound and dynamic scintigraphy, respectively.

Conclusions:

This study shows the feasibility of noninvasive assessment of splenic and portal hemodynamic parameters by DCE imaging using a combination of tracer kinetics modeling techniques.

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