Capabilities of perfusion computed tomography in colorectal cancer detection and differential diagnosis of pathological conditions of the colon. Early results

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Abstract

The article presents the results of preoperative CT diagnostics of colorectal cancer using perfusion technique. It was found that CT perfusion can improve the diagnostics of local prevalence of colon cancer compared to standard computed tomography, as well as to differentiate colorectal cancer and inflammatory bowel disease.

About the authors

Maksim Yu. Kabanov

The Hospital for Veterans of Wars; North-Western State Medical University named after I.I. Mechnikov

Email: chief@gvv-spb.ru

Doctor of Medical Sciences, professor; Chief physician of The Hospital for Veterans of Wars

Russian Federation, 21-2, Narodnaya str., Saint-Petersburg, 193079; 41, Kirochnaya street, Saint-Petersburg, 191015

Irina K. Borovik

The Hospital for Veterans of Wars

Author for correspondence.
Email: dr.borowik@yandex.ru

Radiologist of CT department of The Hospital for Veterans of Wars

 

Russian Federation, 21-2, Narodnaya str., Saint-Petersburg, 193079

Mariya Ya. Belikova

The Hospital for Veterans of Wars; North-Western State Medical University named after I.I. Mechnikov

Email: belikova.mariya@mail.ru

Candidate of Medical Sciences, Associate Professor of the Department of Radiation Diagnostics and Radiotherapy; Head of Computed Tomography department of The Hospital for Veterans of Wars

Russian Federation, 21-2, Narodnaya str., Saint-Petersburg, 193079; 41, Kirochnaya street, Saint-Petersburg, 191015

Konstantin V. Sementsov

The Hospital for Veterans of Wars; North-Western State Medical University named after I.I. Mechnikov

Email: zam.hir@gvv-spb.ru

Candidate of Medical Sciences, Assistant of the Department of General Surgery; deputy chief of the hospital for surgery of The Hospital for Veterans of Wars

Russian Federation, 21-2, Narodnaya str., Saint-Petersburg, 193079; 41, Kirochnaya street, Saint-Petersburg, 191015

Irina E. Itskovich

North-Western State Medical University named after I.I. Mechnikov

Email: itskovichirina@mail.ru

Doctor of Medical Sciences, professor; Head of the Department of Radiation Diagnostics and Radiotherapy

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

Timofey L. Gorshenin

The Hospital for Veterans of Wars; North-Western State Medical University named after I.I. Mechnikov

Email: tgorshenin@mail.ru

Candidate of Medical Sciences, Associate Professor of the Department of General Surgery; Head of the 7th Department of Surgery of The Hospital for Veterans of Wars

Russian Federation, 21-2, Narodnaya str., Saint-Petersburg, 193079; 41, Kirochnaya street, Saint-Petersburg, 191015

Evgeniy V. Rozengauz

North-Western State Medical University named after I.I. Mechnikov

Email: rozengaouz@yandex.ru

Doctor of Medical Sciences, professor of the Department of Radiation Diagnostics and Radiotherapy of the North-Western Medical University named after I.I.Mechnikova.

Russian Federation, 41, Kirochnaya street, Saint-Petersburg, 191015

References

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  4. Злокачественные новообразования в России в 2016 году (заболеваемость и смертность) / под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. – М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России, 2018. – С. 236. [Zlokachestvennyye novoobrazovaniya v Rossii v 2016 godu (zabolevaemost’ i smertnost’). Ed. by A.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Moscow: Moscow scientific research oncological Institute named after P.A. Herzen branch of FSBI National medical research center for radiology of the Ministry of Health of Russia; 2018. P. 236. (In Russ.)]
  5. Глушков Н.И., Горшенин Т.Л., Дулаева С.К. Диагностика и хирургическая тактика при сочетанных осложнениях рака ободочной кишки у больных пожилого и старческого возраста // Вестник Северо-Западного государственного медицинского университета им. И.И. Мечникова. – 2018. – Т. 10. – № 2. – С. 79–86. [Glushkov NI, Gorshenin TL, Dulaeva SK. Diagnostics and surgical tactics in case of combined complications of colon cancer in elderly and senile patients. Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):79-86. (In Russ.)]. https://doi.org/10.17816/mechnikov201810279-86.
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Supplementary files

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2. Fig. 1. CT perfusion. Parametric maps: a — blood volume; b — blood flow; c — mean transit time of contrast medium. Strong vascularization of the rectosigmoid junction tumor in ROI 2 area

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3. Fig. 2. The density-time graph showing the changes of contrast density in time in the area of interest (curve 2, corresponds to ROI 2 area in Fig. 1) relative to the blood flow in the afferent vessel (curve 1)

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4. Fig. 3. Summary table of perfusion parameters in ROI 2 in Fig. 1

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5. Fig. 4. CT perfusion (a, b). Parametric maps: a — volume and b — blood flow showing pathological increased blood flow in the descending colon tumor (arrows); c — HCT. Multiplanar reconstruction in the axial plane in the portal phase of scanning

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6. Fig. 5. CT perfusion (a, b). Parametric maps: a — volume and b — blood flow showing pathological increased blood flow in the paracolic lymph node (arrows); c — HCT. Multiplanar reconstruction in the axial plane in the portal phase of scanning

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7. Fig. 6. CT, multiplanar reconstruction in the axial plane in the arterial phase (a), with a thin dividing strip of adipose tissue between ascending colon tumor and the kidney capsule; b — CT perfusion, parametric map of the blood volume showing the invasion of the adipose tissue and the kidney capsule by the ascending colon tumor

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8. Fig. 7. HCT, multiplanar reconstruction in the axial plane in the portal phase (a) and СT perfusion, parametric map of the blood flow (b) with ROI 2 in the invasive part of the tumor and ROI 3 in the intact intestinal walls

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9. Fig. 8. Summary tables of perfusion parameters (а), the density-time graph (b) for the ROI 2 area in the tumor and ROI 3 in the intact intestinal wall

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10. Fig. 9. HCT. Multiplanar reconstructions in: a — coronal and b — sagittal planes in the portal phase demonstrating thickened walls of the ascending colon (blue arrow) and paracolic abscess in the lateral canal (yellow arrow)

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11. Fig. 10. HCT. Multiplanar reconstruction in the axial plane to the arterial phase (a) and CT perfusion, parametric map of blood volume (b) with ROI 2 marks in the most vascularized area and ROI 3 in the contralateral intestinal wall

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12. Fig. 11. Summary tables of perfusion parameters (a), the density-time graph (b) for ROI 2 and ROI 3 in thickened colon walls with signs of colitis

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Copyright (c) 2020 Kabanov M.Y., Borovik I.K., Belikova M.Y., Sementsov K.V., Itskovich I.E., Gorshenin T.L., Rozengauz E.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.

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