title: Cystic artery localization with a three-dimensional angiography vessel tracking system compared with conventional two-dimensional angiography.
abstract: OBJECTIVE
  During transcatheter hepatic therapy, the cystic artery feeding the gallbladder may inadvertently be exposed to tumor therapy. Localization of the cystic artery may help prevent exposure. The objective of this study was to compare the application of a vessel tracking system software based on three-dimensional (3D) angiography versus standard two-dimensional (2D) angiography for identifying the cystic artery and its origin.
  
  
  METHODS
  A software system that can rapidly localize the cystic artery from a 3D common hepatic angiogram was applied in 25 patients and was compared with manual localization of the cystic artery with conventional 2D digital subtraction common hepatic angiograms.
  
  
  RESULTS
  With the vessel tracking software prototype, 28 cystic arteries were retrogradely tracked in 25 of 25 cases. The origin sites were correctly located by the software in 27 of 28 cystic arteries, with one mistracked as a result of streak artifact. By contrast, on standard 2D hepatic angiography, the cystic artery was deemed visible with certainty in 12 of 25 cases (P < .001). The vessel tracking system revealed a 56% prevalence of extraanatomic distribution by the cystic artery, with the most common supply going to segment 5 liver parenchyma.
  
  
  CONCLUSIONS
  The 3D vessel rapid tracking system has advantages over conventional 2D hepatic angiography in revealing the cystic artery and its origin site. It is also an important tool to identify the complete distribution of the cystic artery without superselective angiography. Supply to adjacent hepatic parenchyma or tumor by the cystic artery is not insignificant and should be considered during hepatic therapies.
authors.affiliation: Department of Interventional Radiology, Peking University Cancer Hospital and Institute and Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Beijing, China.
authors.forename: Xiaodong
authors.initials: X
authors.lastname: Wang
authors.forename: Rajesh P
authors.initials: RP
authors.lastname: Shah
authors.forename: Majid
authors.initials: M
authors.lastname: Maybody
authors.forename: Karen T
authors.initials: KT
authors.lastname: Brown
authors.forename: George I
authors.initials: GI
authors.lastname: Getrajdman
authors.forename: Carsten
authors.initials: C
authors.lastname: Stevenson
authors.forename: Elena N
authors.initials: EN
authors.lastname: Petre
authors.forename: Stephen B
authors.initials: SB
authors.lastname: Solomon
mesh_terms: D000792:Angiography / Q000379:methods*; D015901:Angiography, Digital Subtraction; D016477:Artifacts; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects; D016009:Chi-Square Distribution; D005704:Gallbladder / Q000098:blood supply*; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000188:drug therapy; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012984:Software