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Objective: To describe a new CT perfusion technique for assessing the dual blood supply in lung cancer and present the initial results. Methods: This study was approved by the institutional review board. A CT protocol was developed, and a dual-input CT perfusion (DI-CTP) analysis model was applied and evaluated regarding the blood flow fractions in lung tumours. The pulmonary trunk and the descending aorta were selected as the input arteries for the pulmonary circulation and the bronchial circulation respectively. Pulmonary flow (PF), bronchial flow (BF), and a perfusion index (PI, = PF/ (PF + BF)) were calculated using the maximum slope method. After written informed consent was obtained, 13 consecutive subjects with primary lung cancer underwent DI-CTP. Results: Perfusion results are as follows: PF, 13.45 ± 10.97 ml/min/100 ml; BF, 48.67 ± 28.87 ml/min/100 ml; PI, 21 % ± 11 %. BF is significantly larger than PF, P < 0.001. There is a negative correlation between the tumour volume and perfusion index ( r = 0.671, P = 0.012). Conclusion: The dual-input CT perfusion analysis method can be applied successfully to lung tumours. Initial results demonstrate a dual blood supply in primary lung cancer, in which the systemic circulation is dominant, and that the proportion of the two circulation systems is moderately dependent on tumour size. Key Points: [ABSTRACT FROM AUTHOR]

Quantification of the 11C-acetate liver studies with dynamic positron emission tomography (PET) could significantly improve the evaluation of hepatocellular carcinoma (HCC), where both time-activity curves (TACs) of the hepatic artery (HA) and portal vein (PV) (the dual hepatic blood supply) are required. However, directly measuring them by the blood sampling or cannulation procedure is very invasive. In addition, it is very hard to differentiate the PV from the surrounding liver tissue on PET images by the currently developed indirect methods. To noninvasively and efficiently access the TAC of PV, we investigated the possibility of modeling the dual hepatic blood supply and presented two hepatic dual-input (DI) models. Combining the established 11C-acetate liver model with two different DI models, we obtained two dual-models with six/seven parameters to fit the dynamic PET measurements. The fitting results were compared with those of the 11C-acetate liver model using image-derived dual hepatic inputs (the "Golden standard") by statistical study. The adequacy of the two dual-models was estimated by Akaike Information Criteria (AIC) and Schwarz Criteria (SC). It was revealed that the proposed modeling technique could successfully account for the hepatic dual blood supply and the six-parameter (6-P) dual-model is more suitable for quantification of 11C-acetate liver studies. [ABSTRACT FROM PUBLISHER]