Quantitative assessment of effects of motion compensation for liver and lung tumors in CT perfusion

Rationale and Objectives: To study the effects of four different rigid alignment approaches on both temporal concentration curves (TCCs) and perfusion maps in computed tomography perfusion (CTp) studies of liver and lung tumors. Materials and Methods: Eleven data sets in patients who were subjected to axial CTp after contrast agent administration were assessed. Each data set consists of four different sequences, according to the different rigid alignment configurations considered to compute blood flow perfusion maps: no alignment, translational, craniocaudal, and three dimensional (3D). The color maps were built on TCCs according to the maximum slope method. The effects of motion correction procedures on the reliability of TCCs and perfusion maps were assessed both quantitatively and visually. Results: TCCs built after 3D alignments show the best indices and produce the most reliable maps. We show examinations in which the translational alignment only yields more accurate TCCs but less reliable perfusion maps than those achieved with no alignment. Furthermore, we show color maps with two different perfusion patterns, both considered reliable by radiologists, achieved with different motion correction approaches. Conclusions: The quantitative index we conceived allows relating quality of 3D alignment and reliability of perfusion maps. A better alignment does not necessarily yield more reliable perfusion values: color maps resulting from either alignment procedure must be critically assessed by radiologists. This achievement will hopefully represent a step forward for the clinical use of CTp studies for staging, prognosis, and monitoring values of therapeutic regimens.