title: Evaluating tumors in transcatheter arterial chemoembolization (TACE) using dual-phase cone-beam CT.
abstract: C-arm cone-beam computed tomography (CBCT) can be used to visualize tumor-feeding vessels and parenchymal staining during transcatheter arterial chemoembolization (TACE). To capture these two phases, all current commercially available CBCT systems necessitate two separate contrast-enhanced scans. In this feasibility study, we report initial results of novel software that enhanced our current CBCT system to capture these two phases using only one contrast injection. Novelty of this work is the addition of software that enabled the acquisition of two sequential, back-to-back CBCT scans (dual-phase CBCT, DPCBCT) so both tumor feeding vessels and parenchyma are captured using only one contrast injection. To illustrate our initial experience, DPCBCT was used for TACE treatments involving lipiodol, drug-eluting beads, and Yttrium-90 radioembolizing microspheres. For each case, the DPCBCT images were compared to pre-intervention contrast-enhanced MR/CT. DPCBCT is feasible for TACE treatments and the preliminary results show positive correlation with pre-intervention conventional CT and MR. In addition, the degree of embolization can be monitored. DPCBCT is a promising technology that provides comprehensive visualization of tumor-feeding vessels and parenchymal staining using a single injection of contrast. DPCBCT could potentially be used during TACE to verify catheter position and monitor the embolization effect.
authors.affiliation: Philips Research North America, Briarcliff Manor, NY , USA. Ming.Lin@philips.com
authors.forename: Mingde
authors.initials: M
authors.lastname: Lin
authors.forename: Romaric
authors.initials: R
authors.lastname: Loffroy
authors.forename: Niels
authors.initials: N
authors.lastname: Noordhoek
authors.forename: Katsuyuki
authors.initials: K
authors.lastname: Taguchi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Radaelli
authors.forename: Järl
authors.initials: J
authors.lastname: Blijd
authors.forename: Angelique
authors.initials: A
authors.lastname: Balguid
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Geschwind
mesh_terms: D000368:Aged; D000818:Animals; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D003287:Contrast Media / Q000008:administration & dosage; D004998:Ethiodized Oil / Q000008:administration & dosage; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000098:blood supply / Q000628:therapy*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D013552:Swine; D015021:Yttrium Radioisotopes / Q000008:administration & dosage
chemical_list: D003287:Contrast Media; D015021:Yttrium Radioisotopes; D004998:Ethiodized Oil