Patient History

A 73 year old female presented with a change in bowel habit. Faecal occult blood testing was positive. A sigmoid tumour was only visualised following air insufflation (Figure 1), and confirmed by endoscopic biopsy and subsequent surgery as a moderately differentiated adenocarcinoma (TNM stage - T3, N0, M0).
A CT perfusion study was performed prior to the portal venous abdominal pelvic diagnostic scan. BV, BF, MTT and PS maps show a heterogenous tumour (Figure 2).

CT Perfusion Findings

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Figure 1a.	Figure 1b.
The sigmoid tumour is difficult to appreciate prior to air insufflation
Figures 2
Blood volume map	Blood flow map
Mean transit time map	Permeability map

Blood volume, blood flow, mean transit time and permeability within the tumour.

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Acquisition Parameters

• Acquisition time: 65s
• Rotation speed: 1s
• Collimation: 4 x 5 mm
• Scan delay: 5 seconds
• Scanner: 4-slice LightSpeed Plus
• Tube voltage: 120 kV
• Tube current: AutoMa 80 mA
• Contrast agent: 350 Omnipaque - 100 cc at 5ml/s