title: Dynamic Measurement of Arterial Liver Perfusion With an Interventional C-Arm System.
abstract: Objective intraprocedural measurement of hepatic blood flow could provide a quantitative treatment end point for locoregional liver procedures. This study aims to validate the accuracy and reproducibility of cone-beam computed tomography perfusion (CBCTp) measurements of arterial liver perfusion (ALP) against clinically available computed tomography perfusion (CTp) measurements in a swine embolization model.
  
  
  
  Triplicate CBCTp measurements using a selective arterial contrast injection were performed before and after complete embolization of the left lobe of the liver in 5 swine. Two CBCTp protocols were evaluated that differed in sweep duration (3.3 vs 4.5 seconds) and the number of acquired projection images (166 vs 248). The mean ALP was measured within identical volumes of interest selected in the embolized and nonembolized regions of the perfusion map generated from each scan. Postembolization CBCTp values were also compared with CTp measurements.
  
  
  
  The 2 CBCTp protocols demonstrated high concordance correlation (0.90, P < 0.001). Both CBCTp protocols showed higher reproducibility than CTp in the nontarget lobe, with an intraclass correlation of 0.90 or greater for CBCTp and 0.83 for CTp (P < 0.001 for all correlations). The ALP in the embolized lobe was nearly zero and hence excluded for reproducibility. High concordance correlation was observed between the CTp and each CBCTp protocol, with the shorter CBCTp protocol reaching a concordance correlation of 0.75 and the longer achieving 0.87 (P < 0.001 for both correlations).
  
  
  
  Dynamic blood flow measurement using an angiographic C-arm system is feasible and produces quantitative results comparable to CTp.
authors.affiliation: From *Siemens Medical Solutions Inc, Malvern, PA; †Siemens Healthcare GmbH, Forchheim, Germany; ‡Stanford University School of Medicine; §Stanford Healthcare, Stanford, CA.
authors.forename: Sanjit
authors.initials: S
authors.lastname: Datta
authors.forename: Kerstin
authors.initials: K
authors.lastname: Müller
authors.forename: Terilyn
authors.initials: T
authors.lastname: Moore
authors.forename: Lior
authors.initials: L
authors.lastname: Molvin
authors.forename: Sonja
authors.initials: S
authors.lastname: Gehrisch
authors.forename: Jarrett
authors.initials: J
authors.lastname: Rosenberg
authors.forename: Yamil
authors.initials: Y
authors.lastname: Saenz
authors.forename: Michael
authors.initials: M
authors.lastname: Manhart
authors.forename: Yu
authors.initials: Y
authors.lastname: Deuerling-Zheng
authors.forename: Nishita
authors.initials: N
authors.lastname: Kothary
authors.forename: Rebecca
authors.initials: R
authors.lastname: Fahrig
mesh_terms: D000818:Animals; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation* / Q000379:methods*; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005240:Feasibility Studies; D005260:Female; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D008099:Liver / Q000098:blood supply* / Q000000981:diagnostic imaging*; D023421:Models, Animal; D010865:Pilot Projects; D015203:Reproducibility of Results; D013552:Swine
chemical_list: D003287:Contrast Media