title: Cone-Beam CT Angiography for Determination of Tumor-Feeding Vessels During Chemoembolization of Liver Tumors: Comparison of Conventional and Dedicated-Software Analysis.
abstract: OBJECTIVE
  To compare the ability of dedicated software and conventional cone-beam computed tomography (CT) analysis to identify tumor-feeding vessels in hypervascular liver tumors treated with chemoembolization.
  
  
  METHODS
  Between January 2012 and January 2013, 45 patients (32 men, mean age of 61 y; range, 27-85 y) were enrolled, and 66 tumors were treated (mean, 32 mm ± 18; range, 10-81 mm) with conventional chemoembolization with arterial cone-beam CT. Data were independently analyzed by six interventional radiologists with standard postprocessing software, a computer-aided analysis with FlightPlan for liver (FPFL; ie, "raw FPFL"), and a review of this computer-aided FPFL analysis ("reviewed FPFL"). Analyses were compared with a reference reading established by two study supervisors in consensus who had access to all imaging data. Sensitivities, positive predictive values (PPVs), and false-positive (FP) ratios were compared by McNemar, χ(2), and Fisher exact tests. Analysis durations were compared by Mann-Whitney test, and interreader agreement was assessed.
  
  
  RESULTS
  Reference reading identified 179 feeder vessels. The sensitivity of raw FPFL was significantly higher than those of reviewed FPFL and conventional analyses (90.9% vs 83.2% and 82.1%; P < .0001), with lower PPV (82.9% vs 91.2% and 90.6%, respectively; P < .0001), higher FP ratio (17.1% vs 9.4% and 8.8%, respectively; P < .0001), and greater interreader agreement (92% vs 80% and 79%, respectively; P < .0001). Reviewed FPFL analysis took significantly longer than both other analyses (P < .0001).
  
  
  CONCLUSIONS
  The FPFL analysis software enabled a fast, accurate, and sensitive detection of tumor feeder vessels.
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris; Institut National de la Santé et de la Recherche Médicale U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris. Electronic address: maxime.ronot@bjn.aphp.fr.
authors.forename: Maxime
authors.initials: M
authors.lastname: Ronot
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Rehim
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris; Institut National de la Santé et de la Recherche Médicale U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris.
authors.forename: Antoine
authors.initials: A
authors.lastname: Hakimé
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris; Institut National de la Santé et de la Recherche Médicale U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris.
authors.forename: Viseth
authors.initials: V
authors.lastname: Kuoch
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy.
authors.forename: Marion
authors.initials: M
authors.lastname: Roux
authors.affiliation: Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
authors.forename: Mélanie
authors.initials: M
authors.lastname: Chiaradia
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris; Institut National de la Santé et de la Recherche Médicale U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris.
authors.forename: Valérie
authors.initials: V
authors.lastname: Vilgrain
authors.affiliation: Department of Interventional Radiology, Gustave Roussy, Villejuif, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: de Baere
authors.affiliation: Department of Radiology, University Hospitals Paris Nord Val de Seine, Hôpital Beaujon, Clichy; Université Paris Diderot, Sorbonne Paris Cité, Paris; Institut National de la Santé et de la Recherche Médicale U1149, Centre de Recherche Biomédicale Bichat-Beaujon, Paris.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Deschamps
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D016461:Chemoembolization, Therapeutic; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging; D008113:Liver Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012984:Software