Perfusion computed tomography for neck masses

PurposeComputed tomography (CT) and magnetic resonance imaging(MRI) are very sensitive methods to defining anatomy and patology of head and neck, however they are limited in defining the pathophysiology of the anomalous tissue. Recently, dynamic contrast-enhanced perfusion tomography(CTP) technique which has been started to be applied newly is trying to overcome these limitations. Dynamic imaging has a limitation of getting sections during bolus contrast injection. The major advantages of CTP are easy access, simple application and being a cheaper examination method.The aim of our study is to research the benefits of CTP on benign-malignant mass differentiation by reevaluating the data and images of the patients with neck masses who have been examined with dynamic contrast-enhanced CT in our hospital retrospectively with the aid of software on equipments.Materials and MethodsThe CT perfusion images and data of the patients with neck masses who have been forwarded to our department for dynamic neck CT have been obtained using a Siemens Somatom-Emotion Spiral CT with IV contrast agent applied with an automatical injector(Medrad Viston CT injection) with the aid of a software.FindingsThe perfusion images of two patient groups with of 11 malignant and 24 benign lesions were obtained. When the perfusion parameters were analysed, it was shown that the blood volume and permability values of bothgroups(benign ve malignant)(BV= 91,0886 mL/100g and CP=95,5800 mL/100g/min) showed statistically significant difference(p<0,05) from the muscle tissue(BV=22,9171 mL/100g ve CP=22,2657 mL/100g/min). Likewise, when benign and malignant masses were evaluated seperately, the blood volume and permeability values were much different than muscle tissue and the difference between them were found to be statistically meaningful(p<0,05).The comparision of perfusion parameter values between malignant and benign masses showed that the blood volume values were higher on malignant masses(BV=142,9455 mL/100g for malignant and BV=67,3208 mL/100g for benign masses) and the difference was meaningful(p= ,030). Permeability values were lower on malignant masses(CP=60,1273 mL/100g/min for malignant and CP=111,8292 mL/100g/min for benign masses) but the difference was found insignificant(p= ,206).ConclusionOur study showed that BV value, which is one of the perfusion parameters is useful in distinguishing benign and malignant procesess. However a statistically significant differecence couldn?t be found between the CP values of benign and malignant masses. We believe that when the possibility of getting different results, based on the applied method, heterogenity of lesions, artefacts and the motion of patients were considered studies which includes series with higher number of homogenised patients are needed to display the effectiveness of BTP method for benign-malignant analysis of neck mass.