CT volume perfusion

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Two of this morning's sessions looked at CT perfusion imaging, which is increasingly important as antiangiogenic cancer therapies become more widespread. As Anno Graser, MD, of the University of Munich, explained, "With antiangiogenic therapies, imaging should be of tumor vasculature, not tumor size" -- meaning an approach that simultaneously assesses both morphology and perfusion would be ideal. Though perfusion imaging with CT is possible, obviously, it does come with a downside -- more dosage is required in order to get the necessary information. That conundrum was the focus of a talk by Patrik Rogalla, MD, who looked at the balancing act between dose and time resolution inherent to CT volume perfusion. "The key issue is sampling rate," Rogalla noted. "The more scans we acquire, the more dose we need. What we need to do is integrate perfusion into the protocol -- the ultimate goal is to have both morphology and perfusion within the same CT exam." How far off is that goal? According to the preliminary results of a trial being conducted by Graser and colleagues in Germany, it's closer than you think, thanks to ongoing advances in the strength and speed of MDCT. New scanner generations can image much larger areas, and arterial input can be measured directly from any large artery in the scan's field of view. We're on our way . . . --Cat