European Radiology

, Volume 28, Issue 11, pp 4775–4782 | Cite as

Can quantitative iodine parameters on DECT replace perfusion CT parameters in colorectal cancers?

  • Hyo-Jin Kang
  • Se Hyung KimEmail author
  • Jae Seok Bae
  • Sun Kyung Jeon
  • Joon Koo Han



To determine the correlation between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT (PCT) parameters in patients with pathologically proven colorectal cancers (CRC) and to evaluate their reproducibility and respective radiation exposures.


Institutional review board approval and written informed consents were obtained for this study. Forty-one patients with CRCs who underwent same-day DECT and PCT were prospectively enrolled. Three radiologists independently analyzed the iodine concentration of the tumors and iodine ratios [ratio of lesion to aorta (IRa) or to infrarenal IVC (IRv)] from DECT as well as blood flow (BF), blood volume (BV), permeability (PMB), and mean transit time (MTT) from PCT. Pearson R and linear correlation, paired t-test, and intraclass correlation coefficients (ICCs) were used.


Significant correlations were found between iodine parameters from DECT and PCT parameters: iodine concentration of tumors and BV (r = 0.32, p = 0.04), PMB (r = 0.34, p = 0.03), and MTT (r = -0.38, p = 0.02); iodine ratio (IRa) and MTT (r = -0.32, p = 0.04); iodine ratio (IRv) and BF (r = 0.32, p = 0.04) and PMB (r = 0.44, p = <0.01). DECT showed better intra- and interobserver agreements (ICC = 0.98, 0.90 in iodine concentration; 0.98, 0.91 in IRa; and 0.91, 0.93 in IRv, respectively) than PCT (ICC = 0.90, 0.78 in BF; 0.82, 0.76 in BV; 0.75, 0.75 in PMB; 0.64, 0.79 in MTT, respectively). As for radiation dosage, CTDIvol and DLP in DECT (10.48 ± 1.84 mGy and 519.7 ± 116.7 mGy·cm) were significantly lower than those of PCT (75.76 mGy and 911 mGy·cm) (p < 0.01).


Iodine parameters from DECT are significantly correlated with PCT parameters, but have higher intra- and interobserver agreements and lower radiation exposure.

Key Points

• Quantitative iodine concentrations from DECT are significantly correlated with perfusion CT parameters.

• Intra- and interobserver agreements of DECT are better than those of perfusion CT.

• Effective radiation doses of DECT are significantly lower than those of perfusion CT.

• DECT can be used as an alternative to perfusion CT with lower radiation doses.


Colorectal neoplasms Perfusion Multidetector computed tomography 



Blood flow


Blood volume


Colorectal cancer


Computed tomography dose index volume


Dual-energy CT


Dose length product


Intraclass correlation coefficient


Iodine concentration


Iodine concentration ratio of the tumor to aorta


Iodine concentration ratio of the tumor to inferior vena cava


Inferior vena cava


Mean transit time


Microvessel density


Perfusion CT


Permeability surface area product


Region of interest


Vascular endothelial growth factor



This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2016R1A2B4007762).

Compliance with ethical standards


The scientific guarantor of this publication is Se Hyung Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.


• prospective

• cross-sectional study

• performed at one institution


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of RadiologySeoul National University HospitalSeoulKorea
  2. 2.Department of RadiologySeoul National University College of MedicineSeoulKorea
  3. 3.Department of RadiologyInstitute of Radiation Medicine, Seoul National University Medical Research CenterSeoulKorea

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