Cone-Beam CT Hepatic Arteriography in Chemoembolization for Hepatocellular Carcinoma: Angiographic Image Quality and Its Determining Factors |
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| Affiliation: | 1. Department of Radiology, National Cancer Center, Goyang-si Gyeonggi-do;2. Department of Radiology, Seoul National University College of Medicine, Seoul;3. Institute of Radiation Medicine, Seoul National University Medical Research Center, Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Chongno-gu, Seoul, 110-744, Republic of Korea;1. Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea;2. Department of Radiology, Samsung Medical Center, 50 Irwon-Dong, Gangnam Gu, Seoul 135-710, Korea;3. Department of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Gyeonggi-do, Korea;1. Division of Interventional Radiology and Image Guided Medicine, Emory University School of Medicine, Atlanta, Georgia;2. Nuclear Medicine and Molecular Imaging, Emory University School of Medicine, Atlanta, Georgia;3. Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, Georgia;1. Department of Radiology, Tehran University of Medical Sciences, Tehran, Iran;2. Department of General Surgery, Tehran University of Medical Sciences, Tehran, Iran;3. Advanced Diagnostic and Interventional Radiology Research Center, Tehran University of Medical Sciences, Tehran, Iran;1. Division of Vascular and Interventional Radiology, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada;2. Department of Medical Imaging, and Division of General Surgery, Department of Surgery, Toronto General Hospital-University Health Network/University of Toronto, Toronto, Ontario M5G2N2, Canada;3. Department of Diagnostic Imaging , Markham Stouffville Hospital, Markham, Ontario, Canada;1. Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;2. Department of Surgery, Kyoto University Graduate School of Medicine, 54-Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;1. Department of Radiology and Imaging Sciences, Indiana University, Indianapolis, Indiana, 46202;2. Department of Biostatistics, Indiana University, Indianapolis, Indiana, 46202;3. Division of Interventional Radiology, Stanford University, Stanford, California;4. Department of Interventional Radiology, University of California-Los Angeles, Los Angeles, California;5. Division of Interventional Radiology, Northwestern University, Evanston, Illinois |
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| Abstract: | PurposeTo analyze image quality and the factors that determine it for cone-beam computed tomography (CT) hepatic arteriography in chemoembolization for hepatocellular carcinoma (HCC).Materials and MethodsFrom September 2009–December 2010, 399 consecutive patients referred for chemoembolization of HCC were scheduled for cone-beam CT scan. There were 12 patients (3%) excluded because of difficulty with breath-hold. Of the 387 patients who underwent cone-beam CT hepatic arteriography, 100 patients were ultimately included in the study according to inclusion criteria. Maximum intensity projection images were scored for image quality of each segmental hepatic artery. Potential determining factors for image quality were diaphragmatic motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio. The flow rate of contrast media, x-ray delay, and location of the catheter tip were also evaluated.ResultsIt was possible to trace at least subsegmental hepatic arteries in 625 of 700 segments (89.3%) on cone-beam CT hepatic arteriography. Diaphragmatic motion, prominent portal vein enhancement, and low hepatic artery-to-parenchyma enhancement ratio worsened image quality (P < .001, P = .022, and P = .017). Owing to cardiac motion artifacts, image quality of the left lateral segments (S2 and S3) was poorer compared with the remaining hepatic segments (S4–S8).ConclusionsIn most cases, the quality of cone-beam CT hepatic arteriography images was good enough to trace subsegmental hepatic arteries at a minimum. Respiratory and cardiac motion, portal vein enhancement, and hepatic artery-to-parenchyma enhancement ratio significantly affected the image quality of cone-beam CT hepatic arteriography. |
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| Keywords: | A2–A8" },{" #name" :" keyword" ," $" :{" id" :" key0010" }," $$" :[{" #name" :" text" ," _" :" hepatic segmental arteries 2–8 DSA" },{" #name" :" keyword" ," $" :{" id" :" key0020" }," $$" :[{" #name" :" text" ," _" :" digital subtraction angiography HCC" },{" #name" :" keyword" ," $" :{" id" :" key0030" }," $$" :[{" #name" :" text" ," _" :" hepatocellular carcinoma HU" },{" #name" :" keyword" ," $" :{" id" :" key0040" }," $$" :[{" #name" :" text" ," _" :" Hounsfield units MIP" },{" #name" :" keyword" ," $" :{" id" :" key0050" }," $$" :[{" #name" :" text" ," _" :" maximum intensity projection MPR" },{" #name" :" keyword" ," $" :{" id" :" key0060" }," $$" :[{" #name" :" text" ," _" :" multiplanar reformation S1–S8" },{" #name" :" keyword" ," $" :{" id" :" key0070" }," $$" :[{" #name" :" text" ," _" :" hepatic segments 1–8 |
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