A cone-beam volume CT using a 3D angiography system with a flat panel detector of direct conversion type: usefulness for superselective intra-arterial chemotherapy for head and neck tumors.
OBJECTIVE
The development of flat panel detectors (FPDs) has made cone-beam CT feasible for practical use in a clinical setting. Our purpose was to assess the usefulness of cone-beam CT using the FPD in conjunction with conventional digital subtraction angiography (DSA) for performing superselective intra-arterial chemotherapy for head and neck tumors.


METHODS
Twenty-three consecutive patients (43 feeding arteries) were prospectively examined. All of the patients underwent intra-arterial rotational angiography using an FPD system, and the cone-beam CT was reconstructed from the volume dataset. Two radiologists evaluated the quality of the cone-beam CT and then evaluated whether the additional information provided by the cone-beam CT was useful for the interventional procedures.


RESULTS
In 41 (95%) of 43 arteries, the extent of contrast material perfusion was sufficiently visualized on cone-beam CT. In 20 (47%) of 43 arteries, the DSA plus cone-beam CT was superior to the DSA alone regarding the precise understanding of vascular territory of each artery. This information was helpful for predicting the drug delivery for superselective intra-arterial chemotherapy, especially in deeply invasive tumors with multiple feeding arteries.


CONCLUSIONS
In superselective intra-arterial chemotherapy for head and neck tumors, cone-beam CT with FPD provides useful additional information, which allows interventional radiologists to determine the feeders, as well as the dose of antitumor agent for each feeder.
Kakeda
S
S
Department of Radiology, University of Occupational and Environmental Health School of Medicine, Kitakyushu, Japan. kakeda@med.uoeh-u.ac.jp
Korogi
Y
Y
Miyaguni
Y
Y
Moriya
J
J
Ohnari
N
N
Oda
N
N
Nishino
K
K
Miyamoto
W
W
D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000295:instrumentation* / Q000379:methods; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005240:Feasibility Studies; D005260:Female; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D006801:Humans; D007269:Injections, Intra-Arterial / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement / Q000295:instrumentation*; D015641:Radiography, Interventional / Q000295:instrumentation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed / Q000295:instrumentation*; D014963:X-Ray Intensifying Screens
D000970:Antineoplastic Agents