[C-arm computed tomography for transarterial chemoperfusion and chemo-embolization of thoracic lesions].
OBJECTIVE
To evaluate the role of C-arm CT for on-line fluoroscopy in regional transarterial chemoperfusion (TACP) and chemo-embolization (TPCE) of primary and secondary malignant thoracic lesions.


METHODS
From September 2008 to March 2009 a total of 31 patients (20 males and 11 females, average age: 61.7 years, range 22-84 years) with 53 thoracic malignant lesions from different origins (primary or secondary pulmonary carcinoma n=37, pleural mesothelioma n=16) were treated with TACP or TPCE using flat-detector CT (FD-CT). C-arm CT of the latest generation was used to localize the lesion before local chemotherapy (Artis Zeego, Siemens, Erlangen). For TACP a 220 degrees rotation and a volume of 150 ml (ratio of 1:2 contrast/normal saline), delay 2 s and flow 12 ml/s was used. For TPCE a volume of 75 ml (ratio of 1:2 contrast/normal saline), delay 2 s and flow 3 ml/s was used.


RESULTS
TPCE C-arm CT allowed the evaluation of the degree of perfusion of the tumor and the geographic areas of enhancement correlated with the post-interventional lipiodol uptake in MSCT. In TACP the intercostal arteries involved could be visualized and in 30% of interventions the catheter had to be repositioned for the following intervention.


CONCLUSIONS
C-arm CT provides additional information on the vascular characteristics and perfusion of pulmonary lesions resulting in a change of interventional strategy in a relevant number of patients.
Vogl
T J
TJ
Institut für Diagnostische und Interventionelle Radiologie, Klinikum der Johann-Wolfgang-Goethe-Universität, Theodor-Stern-Kai 7, Frankfurt am Main, Germany. T.Vogl@em.uni-frankfurt.de
Naguib
N N
NN
Nour-Eldin
N-E
NE
Lehnert
T
T
Mbalisike
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D055420:Perfusion Imaging / Q000379:methods*; D015641:Radiography, Interventional / Q000379:methods*; D013899:Thoracic Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D000970:Antineoplastic Agents
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