Impact of C-arm CT on hepatic arterial interventions for hepatic malignancies.
OBJECTIVE
To evaluate C-arm computed tomography (CT) and assess its potential impact on hepatic arterial interventions.


METHODS
Between May 2005 and March 2006, all hepatic arterial interventions for hepatic malignancies were retrospectively reviewed. C-arm CT acquisitions were performed as an adjunct to conventional digital subtraction angiography (DSA). The number of procedures with C-arm CT, the acquisitions per intervention, and the procedure time for all interventions were recorded. The added information provided by C-arm CT was scored as category 1 (no additional information); category 2 (added information without impact on procedure management); or category 3 (added information with impact on procedure management). Intervention types included infusions, radioembolization, embolization, and chemoembolization. A two-sided, two-sample t test was used to compare interventions with and without C-arm CT, and P values less than .05 were considered significant.


RESULTS
C-arm CT was used in 86 of 240 interventions (36%) in 135 patients. The mean number of acquisitions per study was 1.9 (range, 1-4). Thirty-five interventions (40.7%) were scored as category 2 and 16 interventions (18.6%) were scored as category 3. Chemoembolization was associated with the highest percentage of C-arm CT investigations classified as category 2 and 3 assessed per intervention. The mean procedure time was significantly longer (18 minutes) when C-arm CT was used (P<.001).


CONCLUSIONS
C-arm CT provides additional imaging information beyond DSA during hepatic arterial interventions (approximately 60%), and this information impacted procedure management in 19% of cases. C-arm CT offers the greatest opportunity for additional information during chemoembolization procedures and is responsible for a significant but acceptable increase in procedure time for this type of hepatic intervention.
Department of Diagnostic Radiology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 325, Houston, TX 77030, USA. mwallace@di.mdacc.tmc.edu
Michael J
MJ
Wallace
Ravi
R
Murthy
Paresh P
PP
Kamat
Teri
T
Moore
Sujaya H
SH
Rao
Joe
J
Ensor
Sanjay
S
Gupta
Kamran
K
Ahrar
David C
DC
Madoff
Stephen E
SE
McRae
Marshall E
ME
Hicks
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D002648:Child; D004621:Embolization, Therapeutic / Q000379:methods*; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008875:Middle Aged; D015641:Radiography, Interventional / Q000295:instrumentation* / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000295:instrumentation* / Q000379:methods*; D016896:Treatment Outcome