title: Objective assessment of transcatheter arterial chemoembolization angiographic endpoints: preliminary study of quantitative digital subtraction angiography.
abstract: OBJECTIVE
  To explore the significance of quantitative digital subtraction angiography (DSA; Q-DSA) in the assessment of chemoembolization endpoints.
  
  
  METHODS
  Twenty patients with hepatocellular carcinoma treated with chemoembolization were included in the study. All DSA series before and after chemoembolization were postprocessed with Q-DSA. The maximal enhancement and time to peak (TTP) were measured for several homologous anatomic landmarks, including the origin and embolized site of the tumor-feeding artery, parenchyma of the tumor, and ostia of the pre- and postprocedure catheter. The TTP, tumor blood supply time, and maximal enhancement of the time density curve (TDC) were analyzed.
  
  
  RESULTS
  Of the 20 DSA series collected, 18 were successfully postprocessed. The TTPs of the landmarks before and after treatment were 3.60 seconds±1.02 and 3.57 seconds±0.78 at the ostia of the catheter, 3.91 seconds±1.01 and 4.09 seconds±1.14 at the origin site of the tumor-feeding artery, and 4.07 seconds±1.02 and 5.60 seconds±1.56 s the embolized site of the main tumor-feeding artery, respectively. Statistical differences were detected between pre- and postprocedural TTP of the embolized site of the feeding artery (P<.01), as well as between pre- and postprocedural tumor blood supply time (P<.01). The mean maximal TDC enhancements of selected tumor spots were 3.01 units±1.04 and 0.81 units±0.35 before and after the procedure (P<.01), respectively.
  
  
  CONCLUSIONS
  Q-DSA may provide a feasible quantitative measurement in the assessment of chemoembolization endpoints.
authors.affiliation: Department of Interventional Radiology, Renji Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China.
authors.forename: Xue-bin
authors.initials: XB
authors.lastname: Zhang
authors.forename: Zhi-Guo
authors.initials: ZG
authors.lastname: Zhuang
authors.forename: Hui
authors.initials: H
authors.lastname: Ye
authors.forename: Janina
authors.initials: J
authors.lastname: Beilner
authors.forename: Markus
authors.initials: M
authors.lastname: Kowarschik
authors.forename: Jie-jun
authors.initials: JJ
authors.lastname: Chen
authors.forename: Jia-chang
authors.initials: JC
authors.lastname: Chi
authors.forename: Jian-rong
authors.initials: JR
authors.lastname: Xu
mesh_terms: D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging* / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods*; D023381:Endpoint Determination / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage*; D010865:Pilot Projects; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000903:Antibiotics, Antineoplastic; D016685:Mitomycin