Assessment of quantitative perfusion parameters by dynamic contrast-enhanced sonography using a deconvolution method: An in vitro and in vivo study

Objectives - The purpose of this study was to investigate the impact of the arterial input on perfusion parameters measured using dynamic contrast-enhanced sonography combined with a deconvolution method after bolus injections of a contrast agent. Methods - The in vitro experiments were conducted using a custom-made setup consisting of pumping a fluid through a phantom made of 3 intertwined silicone pipes, mimicking a complex structure akin to that of vessels in a tumor, combined with their feeding pipe, mimicking the arterial input. In the in vivo experiments, B16F10 melanoma cells were xenografted to 5 nude mice. An ultrasound scanner combined with a linear transducer was used to perform pulse inversion imaging based on linear raw data throughout the experiments. A mathematical model developed by the Gustave Roussy Institute (patent WO/2008/053268) and based on the dye dilution theory was used to evaluate 7 semiquantitative perfusion parameters directly from time-intensity curves and 3 quantitative perfusion parameters from the residue function obtained after a deconvolution process developed in our laboratory based on the Tikhonov regularization method. We evaluated and compared the intraoperator variability values of perfusion parameters determined after these two signal-processing methods. Results - In vitro, semiquantitative perfusion parameters exhibited intraoperator variability values ranging from 3.39% to 13.60%. Quantitative parameters derived after the deconvolution process ranged from 4.46% to 11.82%. In vivo, tumors exhibited perfusion parameter intraoperator variability values ranging from 3.74% to 29.34%, whereas quantitative ones varied from 5.00% to 12.43%. Conclusions - Taking into account the arterial input in evaluating perfusion parameters improves the intraoperator variability and may improve the dynamic contrast-enhanced sonographic technique.