Correlation between Quantitative Perfusion Using Catheter-Directed Computed Tomography and Pulse Volume Recording Tests in Patients with Critical Limb-Threatening Ischemia

Tuesday, March 7, 2023

4:21 PM – 4:30 PM

Location: Phoenix Convention Center, 225AB

Presenting Author(s)

Hideyuki Torikai, MD

Fellow
University of Virginia

Disclosure(s): Siemens Healthineers: Contracted Research (Ongoing)

Author/Co-author(s)

Daniel Sheeran, MD

Assistant Professor
University of Virginia
Luke R. Wilkins, MD, FSIR

Associate Professor
University of Virginia
J. Fritz F. Angle, MD

Director of Interventional Radiology
Department of Radiology and Medical Imaging, University of Virginia

Disclosure(s):

Hideyuki Torikai, MD: Siemens Healthineers: Contracted Research (Ongoing)

Luke R. Wilkins, MD, FSIR: No financial relationships to disclose

J. Fritz F. Angle, MD: No relevant disclosure to display

Purpose: The purpose of this study is to analyze the correlation between quantitative improvement in blood flow to the foot calculated using a catheter-directed foot computed tomography (CT) perfusion study and pulse volume recording (PVR) tests before and after angioplasty in patients with critical limb-threatening ischemia (CLTI).

Materials and Methods: The institutional review board approved this study. Fourteen patients with CLTI who received a catheter-directed foot perfusion CT before and after peripheral artery intervention (angioplasty and stenting) using an Angio-CT scanner were evaluated. Three regions of interest (ROI) were placed on plantar muscles (abductor hallucis, flexor digitorum brevis, and abductor digiti minimi) to calculate muscular perfusion, and four ROIs were placed on skin using the angiosome concept (medial plantar, lateral plantar, dorsal pedis and heal areas) to assess skin perfusion. Blood flow (BFD ml/100g/min), blood volume (BVD ml/100g), and mean transit time (MMTD seconds) were calculated with deconvolution. The pre-and post-angioplasty PVR test results, including the amplitude of the waveform, ankle-brachial index (ABI), and toe-brachial index (TBI) were collected from the medical records.

Results: Pre- and post-angioplasty PVR, ABI, and TBI were collectible in 11, 7, and 8 patients, respectively. There were significant correlations between the improvement of skin BFD and the amplitude on PVR of the ankle (Correlation coefficient 0.655, p = 0.029), and between the improvement of muscle BFD and the amplitude on PVR of the ankle (Correlation coefficient 0.636, p = 0.031). There were no significant associations between the improvement of blood flow to the foot and ABI and TBI.

Conclusion: There was significant correlation between the improvement of skin and muscular blood flow on a catheter-directed foot perfusion CT and the amplitude on PVR of the ankle.