title: Flat-detector computed tomography PBV map in the evaluation of presurgical embolization for hypervascular brain tumors.
abstract: BACKGROUND
  Preoperative embolization of hypervascular brain tumors is frequently used to minimize intraoperative bleeding.
  
  
  OBJECTIVE
  To explore the efficacy of embolization using flat-detector CT (FDCT) parenchymal blood volume (PBV) maps before and after the intervention.
  
  
  METHODS
  Twenty-five patients with hypervascular brain tumors prospectively received pre- and postprocedural FDCT PBV scans using a biplane system under a protocol approved by the institutional research ethics committee. Semiquantitative analysis, based on region of interest measurements of the pre- and post-embolization PBV maps, operating time, and blood loss, was performed to assess the feasibility of PBV maps in detecting the perfusion deficit and to evaluate the efficacy of embolization.
  
  
  RESULTS
  Preoperative embolization was successful in 18 patients. The relative PBV decreased significantly from 3.98±1.41 before embolization to 2.10±2.00 after embolization. Seventeen patients underwent surgical removal of tumors 24 hours after embolization. The post-embolic tumor perfusion index correlated significantly with blood loss (ρ=0.55) and operating time (ρ=0.60).
  
  
  CONCLUSIONS
  FDCT PBV mapping is a useful method for evaluating the perfusion of hypervascular brain tumors and the efficacy of embolization. It can be used as a supplement to CT perfusion, MRI, and DSA in the evaluation of tumor embolization.
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, PR China.
authors.forename: Li-Li
authors.initials: LL
authors.lastname: Wen
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Xin
authors.identifier: http://orcid.org/0000-0001-6822-3268
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Qing-Rong
authors.initials: QR
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Shu-Juan
authors.initials: SJ
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Nanjing University School of Medicine, Nanjing, PR China.
authors.forename: Jin-Long
authors.initials: JL
authors.lastname: Deng
authors.affiliation: Siemens Healthcare China, Shanghai, China.
authors.forename: Kaiyi
authors.initials: K
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, Jinling Hospital, Jinling School of Clinical Medicine, Nanjing Medical University, Nanjing, PR China.
authors.forename: Han-Dong
authors.initials: HD
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001931:Brain Mapping / Q000379:methods / Q000592:standards*; D001932:Brain Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D004621:Embolization, Therapeutic / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods / Q000592:standards*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods / Q000592:standards*
keywords: CT perfusion; Embolic; Tumor