title: Novel Software-Assisted Hemodynamic Evaluation of Pelvic Flow During Chemoperfusion of Pelvic Arteries for Bladder Cancer: Double- Versus Single-Balloon Technique.
abstract: OBJECTIVE
  Approximately 83 % of patients with bladder cancer have achieved a complete response after undergoing a novel bladder preservation therapy involving balloon-occluded intra-arterial infusion chemotherapy (BOAI) using a four-lumen double-balloon catheter, known as the Osaka Medical College regimen. This study aimed to show the quantitative difference in hemodynamics of the bladder arteries using syngo iFlow (Siemens Healthcare, Erlangen, Germany), which provides an automatic tool for quantitative blood flow analysis between double BOAI (D-BOAI) and conventional single BOAI (S-BOAI).
  
  
  METHODS
  Fifty patients were included. The catheters were introduced into both posterior trunks of the internal iliac arteries via contralateral femoral artery access. A side hole between the distal and proximal balloons was placed at the origin of each bladder artery to allow clear visualization of angiographic flow of the injected agent into the urinary bladder. Digital subtraction angiography was used during analysis with the syngo iFlow to evaluate the hemodynamics of the contrast medium in the pelvic arteries during BOAI. The comparative change in the amount of contrast medium in the bladder arteries between D-BOAI and S-BOAI was assessed using syngo iFlow.
  
  
  RESULTS
  One-hundred pelvic sides were analyzed. The amount of contrast medium in the bladder arteries using D-BOAI was more than twice that using S-BOAI (right, 3.03-fold; left, 2.81-fold).
  
  
  CONCLUSIONS
  The amount of contrast medium in the bladder arteries using D-BOAI was higher than that using conventional S-BOAI. This may increase the anticancer drug concentration in the affected bladder, leading to a good clinical response.
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-City, Osaka, 569-8686, Japan. rad105@poh.osaka-med.ac.jp.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-City, Osaka, 569-8686, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-City, Osaka, 569-8686, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Nakai
authors.affiliation: Department of Urology, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-City, Osaka, 569-8686, Japan.
authors.forename: Haruhito
authors.initials: H
authors.lastname: Azuma
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7, Daigakumachi, Takatsuki-City, Osaka, 569-8686, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Narumi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D021721:Balloon Occlusion / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006439:Hemodynamics / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000098:blood supply*; D012984:Software; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000188:drug therapy*
keywords: Double balloon-occluded arterial infusion; Invasive bladder cancer; Syngo iFlow
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