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.
Wallace
Michael J
MJ
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
Murthy
Ravi
R
Kamat
Paresh P
PP
Moore
Teri
T
Rao
Sujaya H
SH
Ensor
Joe
J
Gupta
Sanjay
S
Ahrar
Kamran
K
Madoff
David C
DC
McRae
Stephen E
SE
Hicks
Marshall E
ME
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