• Angiogenesis
• CT perfusion
• Clear cell
• Quantitative imaging
• Renal cell carcinoma

• Humans
• Carcinoma, Renal Cell/diagnostic imaging
• Carcinoma, Renal Cell/pathology
• Kidney Neoplasms/diagnostic imaging
• Kidney Neoplasms/pathology
• Female
• Male
• Retrospective Studies
• Middle Aged
• Tomography, X-Ray Computed/methods
• Aged
• Diagnosis, Differential
• Adult
• Contrast Media
• Sensitivity and Specificity
• Aged, 80 and over
• Predictive Value of Tests
• Biomarkers, Tumor

• CLINICAL TRIALS
• COLORECTAL NEOPLASMS
• DIAGNOSTIC IMAGING
• GENETICS
• IMMUNOLOGY
• MODEL
• NEOVASCULARISATION
• NON-RANDOMISED
• PATHOLOGIC
• PATHOLOGY
• PROGNOSIS
• PROGNOSTIC FACTOR(S)
• STATISTICAL
• TOMOGRAPHY
• X-RAY COMPUTED

• Aged
• Female
• Humans
• Male
• Middle Aged
• Biomarkers, Tumor
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/therapy
• Neoplasm Metastasis
• Neoplasm Staging
• Prognosis
• Prospective Studies
• Tomography, X-Ray Computed

• Prognosis
• Rectal neoplasms
• Tomography
• X-ray computed

• 2022YFS0249 the Key Research Project of Sichuan Province

• apoptosis
• autophagy
• hedgehog pathway
• itraconazole
• machine learning
• melanoma

• Angiogenesis
• CT-perfusion
• Large bowel
• Prognostic model, Neoplasms/primary

• Aged
• Female
• Humans
• Male
• Middle Aged
• Biomarkers, Tumor
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/diagnostic imaging
• Immunohistochemistry
• Neoplasm Recurrence, Local/diagnostic imaging
• Neoplasm Staging
• Prognosis
• Prospective Studies
• Sensitivity and Specificity
• Tomography, X-Ray Computed/methods

• 09/22/49 Health Technology Assessment Programme

• CT perfusion imaging
• Colorectal cancer
• Tumor angiogenesis
• Tumor markers

• Humans
• Colorectal Neoplasms/diagnostic imaging
• Colorectal Neoplasms/blood
• Colorectal Neoplasms/pathology
• Colorectal Neoplasms/blood supply
• Male
• Female
• Retrospective Studies
• Middle Aged
• Adenocarcinoma/diagnostic imaging
• Adenocarcinoma/blood
• Adenocarcinoma/pathology
• Adenocarcinoma/blood supply
• Aged
• Neovascularization, Pathologic/diagnostic imaging
• Neovascularization, Pathologic/blood
• Tomography, X-Ray Computed/methods
• Predictive Value of Tests
• Carcinoembryonic Antigen/blood
• Biomarkers, Tumor/blood
• Adult
• Microvascular Density
• CA-19-9 Antigen/blood
• ROC Curve
• Vascular Endothelial Growth Factor A/blood
• Blood Volume
• Preoperative Care/methods

• Humans
• Artificial Intelligence
• Phantoms, Imaging
• Tomography, X-Ray Computed/methods
• Algorithms
• Image Processing, Computer-Assisted/methods
• Radiation Dosage

• colorectal cancer
• computed tomography
• functional parameter
• t staging
• texture parameter

• Colorectal Neoplasms/diagnostic imaging
• Colorectal Neoplasms/pathology
• Humans
• Retrospective Studies
• Software
• Tomography, X-Ray Computed/methods

The aim of this study was to assess the image quality and diagnostic performance of reconstructed arterial (A) and portal venous (PV) phases in computed tomography perfusion (CTP) scans compared to the corresponding phases in standard 4-phase CT and to assess the utility for LI-RADS classification using CTP and 4-phase 4CT.

A total of 26 scans with each method (CTP and 4-phase CT) from 19 hepatocellular carcinoma patients were analyzed and compared. Arterial and PV phases reconstructed by advanced modeled iterative reconstruction at strength 4 (ADMIRE 4) from raw CTP data were compared with image sets from arterial and PV phases of 4-phase CT (ADMIRE 3) in the same patient with respect to image quality.

Quantitative image analysis showed that reconstructed CTP datasets were equivalent to 4-phase CT image sets. Qualitative image analysis revealed similar lesion detection rates with the 2 methods for patients with an abdominal diameter ≤36 cm and body weight <90 kg, but lower detection rates with CTP for patients with an abdominal diameter >37 cm. There was no difference in Liver Imaging Reporting and Data System (LI-RADS) classifications between the 2 methods.

Reconstructed CTP images can potentially replace 4-phase CT images in patients weighing <90 kg and with a body diameter <37 cm, as the 2 methods are comparable in terms of quantitative image quality and ability to detect and classify lesions based on LI-RADS criteria.

•

Reconstructed A- and PV-CTP images have comparable image quality to 4-phase CT.

Perfusion Computed Tomography (CTp) is an imaging technique which allows quantitative and qualitative evaluation of tissue perfusion through dynamic CT acquisitions. Since CTp is still considered a research tool in the field of abdominal imaging, the aim of this work is to provide a systematic summary of the current literature on CTp in the abdominal region to clarify the role of this technique for abdominal cancer applications.

A systematic literature search of PubMed, Web of Science, and Scopus was performed to identify original articles involving the use of CTp for clinical applications in abdominal cancer since 2011. Studies were included if they reported original data on CTp and investigated the clinical applications of CTp in abdominal cancer.

Fifty-seven studies were finally included in the study. Most of the included articles (33/57) dealt with CTp at the level of the liver, while a low number of studies investigated CTp for oncologic diseases involving UGI tract (8/57), pancreas (8/57), kidneys (3/57), and colon–rectum (5/57).

Our study revealed that CTp could be a valuable functional imaging tool in the field of abdominal oncology, particularly as a biomarker for monitoring the response to anti-tumoral treatment.

• abdominal cancer
• abdominal imaging
• computed tomography perfusion
• perfusion parameter

• A1 astrocyte
• AQP4
• C3
• methylprednisolone
• traumatic spinal cord injury

The purpose of this study was the assessment of volumetric CT perfusion (CTP) of the lower leg musculature in patients with symptomatic peripheral arterial disease (PAD) before and after interventional revascularisation.

Twenty-nine consecutive patients with symptomatic PAD of the lower extremities requiring interventional revascularisation were assessed prospectively. All patients underwent a CTP scan of the lower leg, and hemodynamic and angiographic assessment, before and after intervention. Ankle-brachial pressure index (ABI) was determined. CTP parameters were calculated with a perfusion software, acting on a no outflow assumption. A sequential two-compartment model was used. Differences in CTP parameters were assessed with non-parametric tests.

The cohort consisted of 24 subjects with an occlusion, and five with a high-grade stenosis. The mean blood flow before/after (BFpre and BFpost, respectively) was 7.42 ± 2.66 and 10.95 ± 6.64 ml/100 ml*min⁻¹. The mean blood volume before/after (BVpre and BVpost, respectively) was 0.71 ± 0.35 and 1.25 ± 1.07 ml/100 ml. BFpost and BVpost were significantly higher than BFpre and BVpre in the treated limb (p = 0.003 and 0.02, respectively), but not in the untreated limb (p = 0.641 and 0.719, respectively).

CTP seems feasible for assessing hemodynamic differences in calf muscles before and after revascularisation in patients with symptomatic PAD. We could show that CTP parameters BF and BV are significantly increased after revascularisation of the symptomatic limb. In the future, this quantitative method might serve as a non-invasive method for surveillance and therapy control of patients with peripheral arterial disease.

• CTP imaging of the lower limb in patients with symptomatic PAD seems feasible for assessing hemodynamic differences before and after revascularisation in PAD patients.

• This quantitative method might serve as a non-invasive method, for surveillance and therapy control of patients with PAD.

The online version contains supplementary material available at 10.1007/s00330-021-07692-5.

• Contrast media
• Perfusion imaging
• Peripheral arterial disease
• Volumetric CT

Targeted therapy against tumor angiogenesis is widely used in clinical practice for patients with colorectal liver metastases (CRLM). Possible predictive biomarkers for tumor angiogenesis, such as, microvessel density (MVD), hypoxia and cell proliferation, can be determined using immunohistochemical staining. However, patients ineligible for surgical treatment need to undergo invasive diagnostic interventions in order to determine these biomarkers. CT perfusion (CTP) is an emerging functional imaging technique, which can non-invasively determine vascular properties of solid tumors. The purpose of this study was to evaluate CTP with histological biomarkers in CRLM.

Patients with CRLM underwent CTP one day before liver surgery. CTP analysis was performed on the entire volume of the largest metastases in each patient. Dual-input maximum slope analysis was used and data concerning arterial flow (AF), portal flow (PF) and perfusion index (PI) were recorded. Immunohistochemical staining with CD34, M75/CA-IX and MIB-1 was performed on the rim in the midsection of the tumor to determine respectively MVD, hypoxia and cell proliferation.

Twenty CRLM in 20 patients were studied. Mean size of the largest CRLM was 37 mm (95% CI 21–54 mm). Mean AF and PF were respectively 64 ml/min/100ml (95% CI 48–79) and 30 ml/min/100ml (95% CI 22–38). Mean PI was 68% (95% CI 62–73). No significant correlation was found between tumor growth patterns and CTP (p = 0.95). MVD did not significantly correlate to AF (r = 0.05; p = 0.84), PF (r = 0.17; p = 0.47) and PI (r = -0.12; p = 0.63). Cell proliferation also did not significantly correlate to AF (r = 0.07; p = 0.78), PF (r = -0.01; p = 0.95) and PI (r = 0.15; p = 0.52). Hypoxia did not significantly correlate to AF (r = -0.05; p = 0.83), however, significantly to PF (r = 0.51; p = 0.02) and a trend to negative correlation with PF (r = -0.43; p = 0.06). However, after controlling the false discovery rate, no significant correlation between CTP and used immunohistochemical biomarkers was found.

In conclusion, this feasibility study found a trend to negative correlation between PI and hypoxia, CTP might therefore possibly evaluate this prognostic marker in CRLM non-invasively. However, CTP is not an appropriate technique for the assessment of microvessels or cell proliferation in CRLM.

• Aged
• Biomarkers, Tumor/metabolism
• Colorectal Neoplasms/pathology
• Female
• Humans
• Liver/diagnostic imaging
• Liver/metabolism
• Liver/pathology
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/metabolism
• Liver Neoplasms/secondary
• Male
• Middle Aged
• Neovascularization, Pathologic/diagnostic imaging
• Neovascularization, Pathologic/pathology
• Perfusion Imaging/methods
• Perfusion Imaging/standards
• Tomography, X-Ray Computed/methods
• Tomography, X-Ray Computed/standards
• Tumor Hypoxia

The aim of this study was to compare intravoxel incoherent motion (IVIM) diffusion weighted (DW) MRI and CT perfusion to assess tumor perfusion of pancreatic ductal adenocarcinoma (PDAC).

In this prospective study, DW-MRI and CT perfusion were conducted in nineteen patients with PDAC on the day before surgery. IVIM analysis of DW-MRI was performed and the parameters perfusion fraction f, pseudodiffusion coefficient D*, and diffusion coefficient D were extracted for tumors, upstream, and downstream parenchyma. With a deconvolution-based analysis, the CT perfusion parameters blood flow (BF) and blood volume (BV) were estimated for tumors, upstream, and downstream parenchyma. In ten patients, intratumoral microvessel density (MVD_tumor) and microvessel area (MVA_tumor) were analyzed microscopically in resection specimens. Correlation coefficients between IVIM parameters, CT perfusion parameters, and histological microvessel parameters in tumors were calculated. Receiver operating characteristic (ROC) analysis was performed for differentiation of tumors and upstream parenchyma.

f_tumor significantly positively correlated with BF_tumor (r = 0.668, p = 0.002) and BV_tumor (r = 0.672, p = 0.002). There were significant positive correlations between f_tumor and MVD_tumor/ MVA_tumor (r ≥ 0.770, p ≤ 0.009) as well as between BF_tumor and MVD_tumor/ MVA_tumor (r ≥ 0.697, p ≤ 0.025). Correlation coefficients between f_tumor and MVD_tumor/ MVA_tumor were not significantly different from correlation coefficients between BF_tumor and MVD_tumor/ MVA_tumor (p ≥ 0.400). Moreover, f, BF, BV, and permeability values (PEM) showed excellent performance in distinguishing tumors from upstream parenchyma (area under the ROC curve ≥0.874).

The study shows that IVIM derived f_tumor and CT perfusion derived BF_tumor similarly reflect vascularity of PDAC and seem to be comparably applicable for the evaluation of tumor perfusion for tumor characterization and as potential quantitative imaging biomarker.

DRKS, DRKS00022227, Registered 26 June 2020, retrospectively registered. https://www.drks.de/drks_web/navigate.do?navigationId=trial. HTML&TRIAL_ID=DRKS00022227.

The online version contains supplementary material available at 10.1186/s40644-021-00382-x.

• Diffusion magnetic resonance imaging
• Microvessels
• Pancreatic ductal adenocarcinoma
• X-ray computed tomography

Convective transport is an important phenomenon for nanomedicine delivery. We present an imaging-based approach to recover tissue properties that are significant in the accumulation of nanoparticles delivered via systemic methods. The classical pharmacokinetic analysis develops governing equations for the particle transport from a first principle mass balance. Fundamentally, the governing equations for compartmental mass balance represent a spatially invariant mass transport between compartments and do not capture spatially variant convection phenomena. Further, the parameters recovered from this approach do not necessarily have direct meaning with respect to the governing equations for convective transport. In our approach, a framework is presented for directly measuring permeability in the sense of Darcy flow through porous tissue. Measurements from our approach are compared to an extended Tofts model as a control. We demonstrate that a pixel-wise iterative clustering algorithm may be applied to reduce the parameter space of the measurements. We show that measurements obtained from our approach are correlated with measurements obtained from the extended Tofts model control. These correlations demonstrate that the proposed approach contains similar information to an established compartmental model and may be useful in providing an alternative theoretical framework for parameterizing mathematical models for treatment planning and diagnostic studies involving nanomedicine where convection dominated effects are important.

• Modeling (i.e., heat transfer, ultrasound, EM, integrated, treatment planning); mass transport; mixture theory; Darcy law

The development of new treatment strategies to improve peripheral nerve repair after injury, especially those that accelerate axonal nerve regeneration, is very important. The aim of this study is to elucidate the molecular mechanisms of how bone marrow stromal cell (BMSC)-derived exosomes (EXOs) participate in peripheral nerve regeneration and whether the regenerative effect of EXOs is correlated with dose.

BMSCs were transfected with or without an siRNA targeting Ago2 (SiAgo2). EXOs extracted from the BMSCs were administered to dorsal root ganglion (DRG) neurons in vitro. After 48 h of culture, the neurite length was measured. Moreover, EXOs at four different doses were injected into the gastrocnemius muscles of rats with sciatic nerve crush injury. The sciatic nerve functional index (SFI) and latency of thermal pain (LTP) of the hind leg sciatic nerve were measured before the operation and at 7, 14, 21, and 28 days after the operation. Then, the number and diameter of the regenerated fibers in the injured distal sciatic nerve were quantified. Seven genes associated with nerve regeneration were investigated by qRT-PCR in DRG neurons extracted from rats 7 days after the sciatic nerve crush.

We showed that after 48 h of culture, the mean number of neurites and the length of cultured DRG neurons in the SiAgo2-BMSC-EXO and SiAgo2-BMSC groups were smaller than that in the untreated and siRNA control groups. The average number and diameter of regenerated axons, LTP, and SFI in the group with 0.9 × 10¹⁰ particles/ml EXOs were better than those in other groups, while the group that received a minimum EXO dose (0.4 × 10¹⁰ particles/ml) was not significantly different from the PBS group. The expression of PMP22, VEGFA, NGFr, and S100b in DRGs from the EXO-treated group was significantly higher than that in the PBS control group. No significant difference was observed in the expression of HGF and Akt1 among the groups.

These results showed that BMSC-derived EXOs can promote the regeneration of peripheral nerves and that the mechanism may involve miRNA-mediated regulation of regeneration-related genes, such as VEGFA. Finally, a dose-effect relationship between EXO treatment and nerve regeneration was shown.

• Exosome
• Mesenchymal stem cells
• Neurons
• Regeneration

• Colorectal cancer
• Computed tomography
• Diffusion imaging
• Magnetic resonance imaging
• Parametric imaging
• Perfusion imaging
• Positron emission tomography
• Texture analysis

• Colorectal Neoplasms/diagnostic imaging
• Colorectal Neoplasms/pathology
• Diffusion Magnetic Resonance Imaging
• Female
• Humans
• Image Processing, Computer-Assisted/methods
• Molecular Imaging/methods
• Positron Emission Tomography Computed Tomography

The accuracy of multi-slice computed tomography (CT) in the diagnosis of acute mesenteric ischemia is very high, however, it cannot demonstrate the small embolus of blood vessels and abnormal intestinal blood flow. The intestinal blood flow in chronic mesenteric ischemia decreases whereas there are few morphology changes, which leads to a high misdiagnosis rate of CT and CT angiography. In addition, inflammatory bowel disease, intestinal tumors, and portal hypertension can be diagnosed definitely by conventional CT, but the hemodynamics and microcirculation in these conditions cannot be assessed, which affects the accuracy of clinical staging and the assessment of therapeutic effect. For intestinal diseases, especially mesenteric ischemia, therefore, it is needed not only to make CT morphologic diagnosis but also to further assess the abnormal intestinal blood flow. In recent years, more and more CT and magnetic resonance imaging (MRI)-related new techniques for assessing blood flow have emerged, including CT perfusion, spectral CT imaging, magnetic resonance perfusion imaging, and phase contrast MRI. This paper reviews the clinical application and progress of these techniques for assessing intestinal blood flow.

• Bowel
• Blood flow perfusion
• Computed tomography
• Phase contrast magnetic resonance imaging

• CT
• Cryoablation
• Hepatic
• Ice-ball
• MRI
• Percutaneous

Tumor vascular normalization alleviates hypoxia in the tumor microenvironment, reduces the degree of malignancy, and increases the efficacy of traditional therapy. However, the time window for vascular normalization is narrow; therefore, how to determine the initial and final points of the time window accurately is a key factor in combination therapy. At present, the gold standard for detecting the normalization of tumor blood vessels is histological staining, including tumor perfusion, microvessel density (MVD), vascular morphology, and permeability. However, this detection method is almost unrepeatable in the same individual and does not dynamically monitor the trend of the time window; therefore, finding a relatively simple and specific monitoring index has important clinical significance. Imaging has long been used to assess changes in tumor blood vessels and tumor changes caused by the oxygen environment in clinical practice; some preclinical and clinical research studies demonstrate the feasibility to assess vascular changes, and some new methods were in preclinical research. In this review, we update the most recent insights of evaluating tumor vascular normalization.

• angiogenesis
• time window
• vascular normalization

• Colorectal neoplasms
• Multidetector computed tomography
• Perfusion

• Aged
• Colorectal Neoplasms/diagnosis
• Colorectal Neoplasms/metabolism
• Female
• Humans
• Iodine/pharmacokinetics
• Male
• Middle Aged
• Prospective Studies
• Radiation Dosage
• Radiography, Dual-Energy Scanned Projection/methods
• Reproducibility of Results
• Tomography, X-Ray Computed/methods

• Biopsy
• Brain glioma
• Dynamic contrast-enhanced MRI
• VEGF

The purpose of this retrospective cohort study was to evaluate the clinical value of computed tomographic perfusion imaging (CTPI) parameters in predicting the response to treatment and overall survival in patients with hepatocellular carcinoma (HCC) treated with drug-eluting beads transarterial chemoembolization (DEBTACE).

Between December 2010 and January 2013 eighteen patients (17 men, 1 woman; mean age 69 ± 5.8 years) with intermediate stage HCC underwent CTPI of the liver prior to treatment with DEBTACE. Treatment response was evaluated on follow-up imaging according to modified Response Evaluation Criteria in Solid Tumors. Pre-treatment CTPI parameters were compared between patients with complete response and partial response with a Student t-test. We compared survival times with Kaplan-Meier method.

CTPI parameters of patients with complete response and others did not show statistical significant difference. The mean survival time was 25.4 ± 3.2 months (95%; CI: 18.7-32.1). Survival was statistically significantly longer in patients with hepatic blood flow (BF) lower than 50.44 ml/100 ml/min (p = 0.033), hepatic blood volume (BV) lower than 13.32 ml/100 ml (p = 0.028) and time to peak (TTP) longer than 19.035 s (p = 0.015).

CTPI enables prediction of survival in patients with intermediate stage HCC, treated with DEBTACE based on the pre-treatment values of BF, BV and TTP perfusion parameters. CT perfusion imaging can’t be used to predict treatment response to DEBTACE.

• computed tomography perfusion imaging
• drug-eluting beads transarterial chemoembolization
• hepatocellular carcinoma
• response to treatment
• survival

• Contrast media
• Dual-energy CT
• Hepatocellular carcinoma
• Liver cirrhosis
• Neoplasm metastasis
• Perfusion imaging

• CT-Perfusion
• Deconvolution model
• Gastric cancer
• Neoangiogenesis

• Adult
• Aged
• Biomarkers
• Evaluation Studies as Topic
• Female
• Humans
• Male
• Middle Aged
• Neoadjuvant Therapy
• Reproducibility of Results
• Stomach/diagnostic imaging
• Stomach Neoplasms/diagnostic imaging
• Stomach Neoplasms/therapy
• Tomography, X-Ray Computed/methods
• Treatment Outcome

To investigate the correlation of iodine concentration (IC) generated by spectral computed tomography (CT) with micro-vessel density (MVD) and vascular endothelial growth factor (VEGF) expression in patients with advanced gastric carcinoma (GC).

Thirty-four advanced GC patients underwent abdominal enhanced CT in the gemstone spectral imaging mode. The IC of the primary lesion in the arterial phase (AP) and venous phase (VP) were measured, and were then normalized against that in the aorta to provide the normalized IC (nIC). MVD and VEGF were detected by immunohistochemical assays, using CD34 and VEGF-A antibodies, respectively. Correlations of nIC with MVD, VEGF, and clinical-pathological features were analyzed.

Both nICs correlated linearly with MVD and were higher in the primary lesion site than in the normal control site, but were not correlated with VEGF expression. After stratification by clinical-pathological subtypes, nIC-AP showed a statistically significant correlation with MVD, particularly in the group with tumors at stage T4, without nodular involvement, of a mixed Lauren type, where the tumor was located at the antrum site, and occurred in female individuals. nIC-VP showed a positive correlation with MVD in the group with the tumor at stage T4 and above, had nodular involvement, was poorly differentiated, was located at the pylorus site, of a mixed and diffused Lauren subtype, and occurred in male individuals. nIC-AP and nIC-VP showed significant differences in terms of histological differentiation and Lauren subtype.

The IC detected by spectral CT correlated with the MVD. nIC-AP and nIC-VP can reflect angiogenesis in different pathological subgroups of advanced GC.

• Micro-vessel density
• Iodine concentration
• Spectral computed tomography
• Vascular endothelial growth factor
• Gastric cancer

• Adult
• Aged
• Antigens, CD34/metabolism
• Biopsy
• Carcinoma/diagnostic imaging
• Female
• Humans
• Immunohistochemistry
• Iodine/chemistry
• Linear Models
• Male
• Microcirculation
• Middle Aged
• Neovascularization, Pathologic
• Radiographic Image Interpretation, Computer-Assisted
• Radiography, Abdominal
• Stomach Neoplasms/diagnostic imaging
• Tomography, X-Ray Computed
• Vascular Endothelial Growth Factor A/metabolism

• CT perfusion
• PET
• antiangiogenic therapy
• non–small cell lung cancer
• texture analysis

• Angiogenesis Inhibitors/therapeutic use
• Antineoplastic Agents/therapeutic use
• Biomarkers
• Carcinoma, Non-Small-Cell Lung/diagnosis
• Carcinoma, Non-Small-Cell Lung/drug therapy
• Carcinoma, Non-Small-Cell Lung/mortality
• Female
• Humans
• Image Processing, Computer-Assisted
• Male
• Middle Aged
• Perfusion Imaging
• Positron-Emission Tomography
• Prognosis
• Tomography, X-Ray Computed

• VEGF
• antiangiogenesis
• colorectal cancer
• predictive markers

There are numerous types of head and neck lesions (HNLs), and conventional computed tomography (CT) has low specificity and sensitivity in the definitive and differential diagnosis of HNLs. The aim of the present study was to evaluate the value of perfusion CT (CTP) combined with vascular endothelial growth factor (VEGF) expression in the differentiation between malignant and benign HNLs. In total, 41 HNLs, which were pathologically confirmed, underwent CTP and VEGF expression analysis. All lesions were divided into three groups: Group A, benign hypovascular lesions; Group B, benign hypervascular lesions; and Group C, malignant lesions. Time density curve (TDC) and CTP parameters [maximum intensity projection (MIP), blood volume (BV), blood flow (BF), mean transit time and capillary permeability] were analyzed. The association between perfusion measurements and VEGF was assessed using Pearson's correlation. TDCs were classified into three types, and type I was more frequently identified in benign tumors (Groups A and B) compared with malignant tumors (Group C) (P=0.003). Malignant tumors primarily had a TDC of type II and III. MIP, BF and BV were all significantly higher in Groups B and C compared to Group A (P<0.01). VEGF expression of malignant tumors was significantly higher than benign tumors (P=0.007). No correlation was identified between VEGF and any CTP parameter. The present findings suggest that CTP combined with VEGF may differentiate between malignant and benign HNLs, and between benign hypovascular and hypervascular lesions.

• angiogenesis
• computed tomography
• head and neck lesions
• perfusion
• vascular endothelial growth factor

• Colorectal adenocarcinoma
• Perfusion imaging
• Tomography
• X-ray