title: Assessment of the parenchymal blood volume by C-arm computed tomography for radioembolization dosimetry.
abstract: OBJECTIVE
  Aim of the study was to evaluate the impact of parenchymal blood volume (PBV) C-arm CT in transarterial radioembolization (TARE) planning procedure regarding the appropriateness of segmental blood supply from selective catheter positions defined by angiographic images compared to PBV mapsto determine the influence of changed target volumes on dose calculation.
  
  
  METHODS
  A total of 22 consecutive patients (median age, 62 years) underwent a TARE planning procedure were included in this retrospective study. Selective angiograms and selective PBV C-arm CT (right and left liver lobe) were evaluated in a blinded fashion, regarding segmental hepatic artery variants. Volumetry of target volume and dosimetry of glass and resin microspheres were performed.
  
  
  RESULTS
  Classification of segment IV and segment I to the corresponding target vascular bed supply was correct in 91.0% (20/22) and 86.4% (19/22) for angiography and C-arm CT, respectively. Except one case, all other liver segments were classified properly to the left and right hepatic arterial supply. Based on the mismatch of the angiographic and the C-arm CT approach, changes of target volume were evident in 27.3% of patients, resulting in a mean mismatch volume of 90±54ml (range, 51-198ml) and a percentage of dose differences of 14.2±11.8% and 12.6±10.6% for the right and 12.5±8.5% and 11.1±7.8% for the left liver lobe in glass and resin microspheres, respectively.
  
  
  CONCLUSIONS
  The C-arm CT approach is superior to the angiographic determination of vascular supply of specific liver segments for dosimetry before radioembolization. Especially for unexperienced interventional radiologists or for a complex anatomy, C-arm CT improves individualized dosimetry concepts.
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: gerd.groezinger@med.uni-tuebingen.de.
authors: G
authors: G
authors: Grözinger
authors: University of Tuebingen, Department of Nuclear Medicine, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: juergen.kupferschlaeger@med.uni-tuebingen.de.
authors: J
authors: J
authors: Kupferschläger
authors: University of Tuebingen, Department of Nuclear Medicine, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: helmut.dittmann@med.uni-tuebingen.de.
authors: H
authors: H
authors: Dittmann
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: michael.maurer@med.uni-tuebingen.de.
authors: M
authors: M
authors: Maurer
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: ulrich.grosse@med.uni-tuebingen.de.
authors: U
authors: U
authors: Grosse
authors: University of Tuebingen, Department of Nuclear Medicine, Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: christian.lafougere@med.uni-tuebingen.de.
authors: C
authors: C
authors: la Fougère
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: konstantin.nikolaou@med.uni-tuebingen.de.
authors: K
authors: K
authors: Nikolaou
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: roland.syha@med.uni-tuebingen.de.
authors: R
authors: R
authors: Syha
authors: University of Tuebingen, Department of Diagnostic and Interventional Radiology Hoppe-Seyler-Str. 3, 72076 Tuebingen, Germany. Electronic address: dominik.ketelsen@med.uni-tuebingen.de.
authors: D
authors: D
authors: Ketelsen
mesh_terms: D000368:Aged; D001810:Blood Volume / Q000502:physiology / Q000528:radiation effects*; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: C-arm CT; Dosimetry; Glass microspheres; Resin microspheres; SIRT; TARE; Volumetry